Case Report
Successful Treatment with Intravenous Cyclophosphamide for Refractory Adult-Onset Still’s Disease
Table 1
Laboratory findings on admission.
| Peripheral blood | | Red blood cells | 382 × 106/μL | Hemoglobin | 12.0 g/dL | Hematocrit | 33.9% | White blood cells | 26,000/μL | Neutrophil | 90.0% | Monocyte | 3.0% | Lymphocyte | 5.0% | Platelet | 29.3 × 104/μL | Blood chemistry | | Total protein | 5.7 g/dL | Total bilirubin | 1.0 mg/dL | AST | 34 IU/L (7−33) | ALT | 22 IU/L (5−30) | Lactate dehydrogenase | 1095 IU/L (119−229) | Alkaline phosphatase | 611 IU/L (80−250) | Gamma-glutamyl transpeptidase | 257 IU/L (5−55) | Creatinine kinase | 14 IU/L (60−160) | Total cholesterol | 186 mg/dL | Triglyceride | 225 mg/dL | Blood urea nitrogen | 13.6 mg/dL | Creatinine | 0.4 mg/dL | Alb | 2.1 g/dL | Na | 131 mEq/L | K | 4.1 mEq/L | Cl | 91 mEq/L | Serological tests | | C-reactive protein | 9.95 mg/dL (<30) | Erythrocyte sedimentation rate | 71.0 mm/hr | Ferritin | 11740 ng/mL (<170) | C3 | 142 mg/dL (86–160) | C4 | 26 mg/dL (17–45) | ANA | (—) (<40) | Anti-CCP Ab | <0.6 U/mL (<4.5) | MPO-ANCA | <1.0 U/mL | RR3-ANCA | <1.0 U/mL | IgG | 1340 mg/dL (900–2000) | IgM | 108 mg/dL | IgA | 338 mg/dL | sIL-2R | 1850 U/mL | Coagulation | | PT time (INR) | 67.8% (1.19) | fibrinogen | 684.2 mg/dL | FDP | 13.2 μg/mL | Microbiological test | | HCV-Ab | (—) | HBsAg | (—) | CMV antigenemia | (—) | EBV-EBNA | ×40 | EBV-VCA IgM | <×10 | EBV-VCA IgG | ×160 | Blood culture | (—) | β-D-Glucan | <3.4 pg/mL | Urinalysis | Normal |
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ANA: anti-nuclear antibody; ANCA: antineutrophil cytoplasmic antibody; CMV: cytomegalovirus; EBV EBNA: Epstein-Barr virus, nuclear antigen; EBV-VCA: Epstein-Barr virus viral-capsid antigen; HBsAg: hepatitis B surface antigen; HCV: hepatitis C virus; MMP-3: matrix metalloproteinase-3; MPO: myeloperoxidase; RF: rheumatoid factor; RR3: proteinase 3.
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