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Mod Rheumatol. 2012 Feb;22(1):137-41. doi: 10.1007/s10165-011-0477-9. Epub 2011 Jun 14.

Adult-onset Still's disease with macrophage activation syndrome successfully treated with a combination of methotrexate and etanercept.

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Department of Internal Medicine I, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-cho, Yufu, Oita 879-5593, Japan.


We report a 16-year-old female case of intractable adult-onset Still's disease accompanied by macrophage activation syndrome, who went into full remission after switching from infliximab to etanercept. Although the disease promptly relapsed when etanercept was discontinued, she again responded fully upon the reintroduction of etanercept. Furthermore, the effect of etanercept was apparently enhanced by combining it with a sufficient dose of methotrexate. This combination therapy should be considered as one of treatment options for the disease.

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