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GLASGOW, SCOTLAND — Successful stem cell transplantation in two patients with recalcitrant Still's disease suggests that this approach could offer a viable alternative for patients who do not respond to other therapies, according to Dr. Hanumantha V. Reddy.
Treatment typically includes nonsteroidal anti-inflammatory drugs, high-dose corticosteroids, and intravenous immunoglobulin. Disease-modifying antirheumatic drugs (DMARDs) are sometimes used, although they tend to be more beneficial for the articular symptoms than for the systemic abnormalities, noted Dr. Reddy in a poster session at the annual meeting of the British Society for Rheumatology.
In the first case, explained by Dr. Reddy, a 34-year-old woman had intermittent fever, rash, arthritis that was significantly erosive, leukocytosis, anemia, and elevated inflammatory markers. She was steroid dependent and had not responded to DMARDs or biologic therapies.
She underwent autologous stem cell transplantation in early 2003 and responded well, soon entering remission with normalization of her inflammatory markers. In 2004, she had a successful pregnancy, and she remains in remission, Dr. Reddy reported.
The second stem cell transplantation involved a 24-year-old woman who had been diagnosed with Still's disease at age 14 and had frequent flares but no significant joint damage. She too was steroid dependent and had not responded to traditional DMARDs, biologic therapies, or intravenous immunoglobulin, according to Dr. Reddy of the rheumatology department, Royal Liverpool University Hospital, England.
The patient underwent autologous stem cell transplantation. The posttransplant period was complicated by 3 months of persistent fever, presumed to be viral in origin. She also experienced two episodes of severe autoimmune hemolysis characterized by frank hematuria and the presence of Kidd group antibodies. She recovered well, however, and is currently in remission, Dr. Reddy reported.
Stem cell transplantation risks were seen in a series of 34 children with juvenile idiopathic arthritis who underwent the procedure. Although 53% of patients in this series responded well and experienced drug-free remission, five died—two from disease relapse and three from infection-associated hemophagocytic syndrome (Ann. Rheum. Dis. 2004;63:1318–26).
GLASGOW, SCOTLAND — Successful stem cell transplantation in two patients with recalcitrant Still's disease suggests that this approach could offer a viable alternative for patients who do not respond to other therapies, according to Dr. Hanumantha V. Reddy.
Treatment typically includes nonsteroidal anti-inflammatory drugs, high-dose corticosteroids, and intravenous immunoglobulin. Disease-modifying antirheumatic drugs (DMARDs) are sometimes used, although they tend to be more beneficial for the articular symptoms than for the systemic abnormalities, noted Dr. Reddy in a poster session at the annual meeting of the British Society for Rheumatology.
In the first case, explained by Dr. Reddy, a 34-year-old woman had intermittent fever, rash, arthritis that was significantly erosive, leukocytosis, anemia, and elevated inflammatory markers. She was steroid dependent and had not responded to DMARDs or biologic therapies.
She underwent autologous stem cell transplantation in early 2003 and responded well, soon entering remission with normalization of her inflammatory markers. In 2004, she had a successful pregnancy, and she remains in remission, Dr. Reddy reported.
The second stem cell transplantation involved a 24-year-old woman who had been diagnosed with Still's disease at age 14 and had frequent flares but no significant joint damage. She too was steroid dependent and had not responded to traditional DMARDs, biologic therapies, or intravenous immunoglobulin, according to Dr. Reddy of the rheumatology department, Royal Liverpool University Hospital, England.
The patient underwent autologous stem cell transplantation. The posttransplant period was complicated by 3 months of persistent fever, presumed to be viral in origin. She also experienced two episodes of severe autoimmune hemolysis characterized by frank hematuria and the presence of Kidd group antibodies. She recovered well, however, and is currently in remission, Dr. Reddy reported.
Stem cell transplantation risks were seen in a series of 34 children with juvenile idiopathic arthritis who underwent the procedure. Although 53% of patients in this series responded well and experienced drug-free remission, five died—two from disease relapse and three from infection-associated hemophagocytic syndrome (Ann. Rheum. Dis. 2004;63:1318–26).
GLASGOW, SCOTLAND — Successful stem cell transplantation in two patients with recalcitrant Still's disease suggests that this approach could offer a viable alternative for patients who do not respond to other therapies, according to Dr. Hanumantha V. Reddy.
Treatment typically includes nonsteroidal anti-inflammatory drugs, high-dose corticosteroids, and intravenous immunoglobulin. Disease-modifying antirheumatic drugs (DMARDs) are sometimes used, although they tend to be more beneficial for the articular symptoms than for the systemic abnormalities, noted Dr. Reddy in a poster session at the annual meeting of the British Society for Rheumatology.
In the first case, explained by Dr. Reddy, a 34-year-old woman had intermittent fever, rash, arthritis that was significantly erosive, leukocytosis, anemia, and elevated inflammatory markers. She was steroid dependent and had not responded to DMARDs or biologic therapies.
She underwent autologous stem cell transplantation in early 2003 and responded well, soon entering remission with normalization of her inflammatory markers. In 2004, she had a successful pregnancy, and she remains in remission, Dr. Reddy reported.
The second stem cell transplantation involved a 24-year-old woman who had been diagnosed with Still's disease at age 14 and had frequent flares but no significant joint damage. She too was steroid dependent and had not responded to traditional DMARDs, biologic therapies, or intravenous immunoglobulin, according to Dr. Reddy of the rheumatology department, Royal Liverpool University Hospital, England.
The patient underwent autologous stem cell transplantation. The posttransplant period was complicated by 3 months of persistent fever, presumed to be viral in origin. She also experienced two episodes of severe autoimmune hemolysis characterized by frank hematuria and the presence of Kidd group antibodies. She recovered well, however, and is currently in remission, Dr. Reddy reported.
Stem cell transplantation risks were seen in a series of 34 children with juvenile idiopathic arthritis who underwent the procedure. Although 53% of patients in this series responded well and experienced drug-free remission, five died—two from disease relapse and three from infection-associated hemophagocytic syndrome (Ann. Rheum. Dis. 2004;63:1318–26).