Anakinra
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Injection site reactions: case report An 11-year-old boy developed injection site reactions during treatment with anakinra for systemic juvenile idiopathic arthritis (JIA). The boy was admitted to local hospital with a 1-week history of fever, arthralgia and urticarial rash, which did not improve with unspecified NSAIDs, antibiotic and antihistamine therapy. He underwent extensive investigations and was noted to have marked hyperferritinemia. He was started on prednisone with improvement in his condition. Six months later, his symptoms recurred without fever. He was admitted to the hospital. Based on further investigations, he was diagnosed with systemic JIA-like hyperferritinemic syndrome. He was started on anakinra injection at 5 mg/kg/day (i.e. 100mg twice a day) and methylprednisolone. During the first week of treatment, he developed severe, intractable injection site reactions due to anakinra. Therefore, the boy’s dose of anakinra was initially reduced to 100 mg/day and then anakinra was discontinued. He was then started on ciclosporin with improvement in his condition. On day 45 of admission, his clinical condition worsened. Further investigations indicated impending macrophage activation syndrome, which eventually improved after canakinumab therapy. Papa R, et al. Successful treatment of refractory hyperferritinemic syndromes with canakinumab: A report of two cases. Pediatric Rheumatology 18: No. 1, 11 Jul 2020. 803497142 Available from: URL: http://doi.org/10.1186/s12969-020-00450-9
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Reactions 22 Aug 2020 No. 1818
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