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Intravenous immunoglobulin therapy leading to dramatic improvement in a patient with systemic juvenile idiopathic arthritis and severe pericarditis resistant to steroid pulse therapy

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Abstract

A 7-year-old Japanese boy with a 4-month history of systemic juvenile idiopathic arthritis (s-JIA) experienced disease flare with spiking fever, exanthema and arthralgia. He then developed progressive dyspnea due to severe pericarditis, and proinflammatory hypercytokinemia was suspected. Methylprednisolone pulse therapy was ineffective and echocardiography showed massive pericardial effusion had persisted. Alternatively, subsequent intravenous immunoglobulin (IVIG) therapy resulted in dramatic resolution of the pericardial effusion, and his general condition significantly improved within a few days. This case report may lend further support the use of IVIG for selected patients with s-JIA and severe pericarditis.

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Authors and Affiliations

  1. Department of Pediatrics, Hirosaki University School of Medicine, Hirosaki, 036-8562, Japan

    Tomomi Aizawa-Yashiro, Eishin Oki, Kazushi Tsuruga, Etsuro Ito & Hiroshi Tanaka

  2. Section of Pediatrics, Mutsu General Hospital, Mutsu, Japan

    Tohru Nakahata

Authors
  1. Tomomi Aizawa-Yashiro
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  2. Eishin Oki
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  3. Kazushi Tsuruga
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  4. Tohru Nakahata
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  5. Etsuro Ito
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  6. Hiroshi Tanaka
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Corresponding author

Correspondence to Hiroshi Tanaka.

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Aizawa-Yashiro, T., Oki, E., Tsuruga, K. et al. Intravenous immunoglobulin therapy leading to dramatic improvement in a patient with systemic juvenile idiopathic arthritis and severe pericarditis resistant to steroid pulse therapy. Rheumatol Int 32, 1359–1361 (2012). https://doi.org/10.1007/s00296-010-1413-6

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  • DOI: https://doi.org/10.1007/s00296-010-1413-6

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