Angioedema of the Periorbital Region that Developed during Treatment with Etanercept in a Case of Refractory Adult-Onset Still's Disease

Takashi Kato; Kei Noguchi; Masahiro Uehara; Mamoru Nobuhara; Satoru Takahashi; Yumi Kisamori; Hideki Ikegaya; Noriyoshi Ogawa; Hiroyuki Ohashi

doi:10.2169/internalmedicine.51.8243

CASE REPORTS

Angioedema of the Periorbital Region that Developed during Treatment with Etanercept in a Case of Refractory Adult-Onset Still's Disease

Takashi Kato, Kei Noguchi, Masahiro Uehara, Mamoru Nobuhara, Satoru Takahashi, Yumi Kisamori, Hideki Ikegaya, Noriyoshi Ogawa, Hiroyuki Ohashi

Author information

Takashi Kato
Department of Internal Medicine, Omaezaki Municipal General Hospital, Japan
Kei Noguchi
Department of Ophthalmology, Omaezaki Municipal General Hospital, Japan
Masahiro Uehara
Department of Internal Medicine, Omaezaki Municipal General Hospital, Japan
Mamoru Nobuhara
Department of Internal Medicine, Omaezaki Municipal General Hospital, Japan
Satoru Takahashi
Department of Internal Medicine, Omaezaki Municipal General Hospital, Japan
Yumi Kisamori
Department of Internal Medicine, Omaezaki Municipal General Hospital, Japan
Hideki Ikegaya
Department of Internal Medicine, Omaezaki Municipal General Hospital, Japan
Noriyoshi Ogawa
Division of Rheumatology, Department of the Third Internal Medicine, Hamamatsu University School of Medicine, Japan
Hiroyuki Ohashi
Department of Internal Medicine, Omaezaki Municipal General Hospital, Japan

Keywords: adult-onset Still's disease (AOSD), adverse event, angioedema, etanercept, hypersensitivity

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 19 Pages 2801-2804

DOI https://doi.org/10.2169/internalmedicine.51.8243

Details

Abstract

A 78-year-old Japanese man with adult-onset Still's disease that was refractory to conventional treatment, such as prednisolone (PSL) concomitant with methotrexate (MTX). Etanercept (50 mg/week) was added to PSL (12.5 mg/day) and MTX (12 mg/week). His manifestation improved dramatically, nonetheless massive edema of the periorbital region developed by the fourth injection, which kept his palpebral fissure completely closed. There was also a marked injection site reaction to etanercept. A diagnosis of angioedema due to etanercept was thus made, and the drug was discontinued. His angioedema began to ameliorate soon after antihistamines were introduced without any critical involvement, such as laryngeal obstruction.

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