Macrophage Activation Syndrome Treated with Anakinra
Open accessAbstract
To the Editor: A 32-year-old woman originally from Cambodia (living in Canada since 1993) developed symmetrical polyarthritis involving hands, wrists, and knees. Rheumatoid factor (RF) and anticyclic citrullinated peptide (CCP), antinuclear antibody (ANA), and anti-double-stranded DNA (dsDNA) were negative. A diagnosis of seronegative polyarthritis was made. Treatment was initiated with methotrexate, hydroxychloroquine, and sulfasalazine. Three years later she developed tuberculosis of the spine (Pott’s disease). She underwent surgical debridement and internal fixation of lumbar spine (T12-L1). Antituberculous drugs were initiated. She developed hepatitis secondary to isoniazid and was treated with ethambutol, pyrazinamide, and rifampin for a year, followed by pyrazinamide and rifampin maintenance therapy indefinitely. Four years after the diagnosis of seronegative arthritis, she was readmitted to our hospital with fever (39°C) and a flare of arthritis. She also presented a sterile pharyngitis, polyadenopathy, and small bilateral pleural effusions. No rash was noted during febrile episodes but she is naturally tanned. Laboratory results showed inflammatory anemia, neutrophilia, and elevated ferritin, sedimentation rate, and C-reactive protein (Table 1). Repeat RF, anti-CCP, and anti-dsDNA … Address correspondence to Dr. Durand; E-mail: madeleine.durand{at}gmail.com
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The interleukin-1-receptor antagonist anakinra is effective as a single agent and in combination with other agents for the treatment of some forms of cytokine storm.
“The interleukin-1–receptor antagonist anakinra is effective as a single agent and in combination with other agents for the treatment of some forms of cytokine storm.”
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- Authors
- DURAND, M., TROYANOV, Y., LAFLAMME, P., & GREGOIRE, G.
- Venue
- The Journal of Rheumatology
- Publisher
- The Journal of Rheumatology
- Published
- 2010-04
- Volume
- 37
- Issue
- 4
- Pages
- 879-880
- ISSN
- 0315-162X (ISSN-L)
- 1499-2752
- OpenAlex
- W2088525451
- Cited by
- 86
- References
- 11
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 6 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 8 · 2019: 12 · 2018: 6 · 2017: 7 · 2016: 7 · 2015: 7 · 2014: 7 · 2013: 3 · 2012: 5
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Autoimmune and Inflammatory Disorders Research
- Health Sciences › Medicine › Surgery › Kawasaki Disease and Coronary Complications
- Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
- Keywords
- macrophage activation syndrome, anakinra, seronegative polyarthritis, spinal tuberculosis, isoniazid, tuberculosis treatment, pleural effusion, elevated ferritin, neutrophilia, inflammatory anemia, rheumatoid arthritis
- MeSH terms
- Adult, Female, Humans, Treatment Outcome, Antirheumatic Agents, Interleukin 1 Receptor Antagonist Protein, Macrophage Activation Syndrome
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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