Hoff P, Walther M, Wesselmann H, Weinerth J, Feist E, Ohrndorf S
MVZ Endokrinologikum Berlin am Gendarmenmarkt, Friedrichstr. 76, 10117, Berlin, Deutschland.
Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Deutschland.
Z Rheumatol. 2020 Dec;79(10):1046-1049. doi: 10.1007/s00393-020-00853-9.
A 46-year-old female patient with a known HIV-2-infection suffered from adult onset Still's disease, which was initially complicated by a macrophage activation syndrome (MAS). The required glucocorticoid treatment induced a psychosis and the patient developed an aversion to glucocorticoids. After failure of treatment with anakinra, an alternative option with the JAK-inhibitor tofacitinib was introduced because of the short half-life and to reduce glucocorticoid exposure. A switch to tofacitinib was only successful after an overlapping treatment with anakinra and tofacitinib for 3 weeks. The patient is currently being treated with monotherapy with tofacitinib as well as NSAID on demand, is in stable remission and can continue working as normal.
一名已知感染HIV-2的46岁女性患者患有成人斯蒂尔病,最初并发巨噬细胞活化综合征(MAS)。所需的糖皮质激素治疗引发了精神病,患者对糖皮质激素产生了厌恶。在用阿那白滞素治疗失败后,由于其半衰期短且为减少糖皮质激素暴露,引入了JAK抑制剂托法替布作为替代选择。在阿那白滞素和托法替布重叠治疗3周后,改用托法替布才取得成功。该患者目前正在接受托法替布单药治疗以及按需使用非甾体抗炎药,病情处于稳定缓解状态,可以继续正常工作。