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Anakinra for Recurrent Fevers in Systemic Lupus Erythematosus
Eric Dein1, Ashley Ingolia2, Caoilfhionn Connolly3
1Rheumatology, Johns Hopkins Bayview Medical Center, Baltimore, USA.
Cureus
|March 12, 2019
Summary
Recurrent fevers in systemic lupus erythematosus (SLE) can be effectively managed with anakinra, an interleukin-1 (IL-1) inhibitor. This treatment demonstrated safety and efficacy in a patient with refractory SLE fevers.
Area of Science:
- Rheumatology
- Immunology
- Internal Medicine
Background:
- Fever is a common symptom in Systemic Lupus Erythematosus (SLE), necessitating differential diagnosis to exclude infection, drug reactions, thromboembolism, or malignancy.
- While SLE disease activity can cause fever, other etiologies must be rigorously investigated.
Observation:
- A 44-year-old Peruvian female with SLE experienced recurrent high fevers and elevated high-sensitivity C-reactive protein (hs-CRP) post-partum, leading to frequent hospitalizations.
- The patient was initiated on anakinra, an interleukin-1 (IL-1) inhibitor, for management of her persistent febrile episodes.
Findings:
- Anakinra treatment led to significant improvement in the patient's fevers and joint symptoms.
- Over a 26-month follow-up, the patient experienced only one febrile episode requiring hospitalization, with a notable decrease in CRP levels, indicating sustained clinical benefit.
Implications:
- Interleukin-1 (IL-1) inhibition with anakinra presents a safe and effective therapeutic option for managing recurrent fevers in SLE patients.
- The short half-life of anakinra contributes to its favorable safety profile, making it a viable treatment strategy for refractory SLE-associated fevers.
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