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Anakinra for myocarditis in juvenile idiopathic arthritis
Rajesh Movva1, Suzanne B Brown1, D Lynn Morris1
1Division of Cardiology (Drs. Brown, Figueredo, Morris, and Movva), Einstein Medical Center, Philadelphia, Pennsylvania 19141; and Department of Medicine (Drs. Figueredo and Morris), Jefferson Medical College, Philadelphia, Pennsylvania 19107.
Abstract:
A 20-year-old pregnant woman with a history of juvenile idiopathic arthritis presented with flu-like symptoms, systemic inflammation with myocarditis, and severe cardiomyopathy. Six weeks earlier, her chronic-arthritis therapy had been changed from anakinra, an interleukin-1β receptor antagonist, to etanercept. When she resumed taking anakinra, her condition improved dramatically, including a complete recovery of ventricular function. Myocarditis is a well-recognized complication of systemic vasculitides. This unusual case emphasizes the important pathophysiologic role of interleukin receptors in the successful treatment of myocarditis. We suggest that clinical cardiologists be aware of the therapeutic usefulness of biological agents such as anakinra in patients with rheumatic conditions.
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