Ohe Masashi, Bohgaki Toshiyuki
Bull Hosp Jt Dis (2013). 2015 Jul;73(3):213-6.
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. The mainstays of treatment are glucocorticoids (GCs) and non-steroidal anti-inflammatory drugs, although most cases are refractory to these conventional therapies. Immunosuppressants,such as methotrexate (MTX), cyclosporine A, tumor necrosis factor-α blockers, an interleukin (IL)-1 blocker, and an IL-6, receptor blocker, have been suggested in previous reports for the treatment of steroid-resistant AOSD. We report herein the case of an AOSD patient who was successfully treated with tacrolimus, another immunosuppressant, in combination with GC and MTX. Blood concentrations of tacrolimus were monitored because of the narrow therapeutic window.
成人斯蒂尔病（AOSD）是一种病因不明的罕见全身性炎症性疾病。治疗的主要药物是糖皮质激素（GCs）和非甾体抗炎药，尽管大多数病例对这些传统疗法无效。先前的报告曾建议使用免疫抑制剂，如甲氨蝶呤（MTX）、环孢素A、肿瘤坏死因子-α阻滞剂、白细胞介素（IL）-1阻滞剂和IL-6受体阻滞剂来治疗对类固醇耐药的AOSD。我们在此报告一例AOSD患者，该患者使用另一种免疫抑制剂他克莫司联合GC和MTX成功治愈。由于治疗窗狭窄，对他克莫司的血药浓度进行了监测。
