Abstract
A 41-year-old woman presented with continuous fever, and her laboratory data suggested the recrudescence of systemic lupus erythematosus. She was treated with 60 mg/day prednisolone. With a dose reduction of prednisolone, high fever and pancytopenia were observed again. A bone marrow biopsy revealed hemophagocytosis. The effects of steroid pulse therapy, high-dose intravenous immunoglobulin, cyclosporine A, and methotrexate were insufficient. However, after four injections of etanercept (25 mg, twice a week) subcutaneously, her symptoms had completely resolved. In such cases, therapy with etanercept may be effective.
MeSH terms
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Adult
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Cyclosporine / therapeutic use
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Drug Therapy, Combination
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Etanercept
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Female
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Glucocorticoids / therapeutic use
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Humans
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Immunoglobulin G / administration & dosage
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Immunoglobulin G / therapeutic use*
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Immunoglobulins, Intravenous / therapeutic use
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Immunosuppressive Agents / administration & dosage
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Immunosuppressive Agents / therapeutic use*
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Injections, Subcutaneous
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Lupus Erythematosus, Systemic / complications
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Lupus Erythematosus, Systemic / drug therapy*
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Lupus Erythematosus, Systemic / pathology
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Lymphohistiocytosis, Hemophagocytic / complications
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Lymphohistiocytosis, Hemophagocytic / drug therapy*
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Lymphohistiocytosis, Hemophagocytic / pathology
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Methotrexate / therapeutic use
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Prednisolone / therapeutic use
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Pulse Therapy, Drug
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Receptors, Tumor Necrosis Factor / administration & dosage
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Receptors, Tumor Necrosis Factor / therapeutic use*
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Remission Induction
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Treatment Failure
Substances
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Glucocorticoids
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Immunoglobulin G
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Immunoglobulins, Intravenous
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Immunosuppressive Agents
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Receptors, Tumor Necrosis Factor
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Cyclosporine
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Prednisolone
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Etanercept
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Methotrexate