Naslov
Interleukin-6 levels as indicator of macrophage activation syndrome/relaps in systemic juvenile arthritis during anakinra or tocilizumab treatment

Autori
Kapović, Agneza Marija ; Gagro, Alenka

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Cytokine 59(3) / Gordon W. Duff, S.K. Durum - : Elsevier, 2012, 569-569

Skup
10th Joint Meeting of International Cytokine Society and International Society for Interferon and Cytokine Research

Mjesto i datum
Ženeva, Švicarska, 11.09.2012. - 14.09.2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
interleukin-6; macrophage activation syndrome; juvenile idiopathic arthritis; anakinra; tocilizumab

Sažetak
Introduction: Systemic juvenile idiopathic arthritis (sJIA) without arthritis is a subtype of chronic childhood arthritis of presumed autoinflammatory etiology. It is characterized by prolonged period of spiking fever, skin rash, lymphadenopathy, hepatosplenomegaly, and serositis. Macrophage activation syndrome (MAS), a potentially fatal complication is seen most frequently in this juvenile rheumatic disease. MAS is diagnosed based on the combination of clinical symptoms, cytopenia or sudden decrease of white blood cells and/or platelet count, coagulopathy, and liver dysfunction in the absence of infection. Ample evidence supports the hypothesis that MAS is one of many presentations of cytokine storm scenarios in human diseases. Some of these cytokines are target molecules of biologic therapy in sJIA such as interleukin (IL)-1 and IL-6. In addition to anakinra, recombinant IL-1RA, a tocilizumab (TCZ), a humanized anti-IL-6 receptor monoclonal antibody, is approved for treatment of sJIA also. Methods: Here we present a comparison of laboratory findings of two separate acute non- infectious exacerbations in a 6 years old girl with multiple-drug resistant sJIA that developed during treatment with anakinra or TCZ. Results: Although both treatments resulted in rapid resolution of systemic symptoms initially, anakinra treatment was superior in the length of disease remission. Treatment with anakinra did not interfere with findings of laboratory evaluation recommended for diagnosis of the acute phase of sJIA and/or MAS. In contrast to anakinra, TCZ blocked the production of C-reactive protein while other soluble markers such as serum IL-6, procalcitonin, and ferritin were unaffected. Conclusion: These findings indicate that laboratory monitoring of exacerbations in sJIA patients should be tailored based on the type of the blockade of a single cytokine pathway (IL-1 or IL-6).

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA