Diallo A, Mekinian A, Boukari L, Mouas H, Zamy M, Nahon P, Gérin M, Fain O
Service de médecine interne, université Paris 13, hôpital Jean-Verdier, AP-HP, Bondy, France.
Rev Med Interne. 2013 Mar;34(3):168-70. doi: 10.1016/j.revmed.2012.10.372. Epub 2012 Nov 20.
Adult-onset Still's disease is characterized by non-specific polymorphic features. The efficacy of anakinra, an IL-1 receptor antagonist, has been shown in several studies. This medication is well-tolerated, and only one case of severe hepatitis has been previously reported.
A 22-year-old woman presented with fever, rash, arthritis, and pericarditis, associated with systemic inflammatory response syndrome and elevated ferritin serum level with low glycosylated ferritin. Adult-onset Still's disease was diagnosed, but treatment with steroids did not achieve remission. The patient was then treated with anakinra, which resulted in spectacular improvement, but 3 weeks after the initiation of the treatment she experienced severe hepatitis that resolved after the discontinuation of anakinra.
Hepatitis is a rare side effect of anakinra and the monitoring of liver tests should be recommended during anakinra therapy.
成人斯蒂尔病具有非特异性多形性特征。多项研究已表明白细胞介素-1受体拮抗剂阿那白滞素的疗效。这种药物耐受性良好，此前仅报告过一例严重肝炎病例。
一名22岁女性出现发热、皮疹、关节炎和心包炎，伴有全身炎症反应综合征以及血清铁蛋白水平升高且糖化铁蛋白水平降低。诊断为成人斯蒂尔病，但使用类固醇治疗未实现缓解。随后该患者接受阿那白滞素治疗，病情显著改善，但治疗开始3周后她出现严重肝炎，停用阿那白滞素后肝炎得以缓解。
肝炎是阿那白滞素罕见的副作用，在阿那白滞素治疗期间应建议监测肝功能检查。
