Successful treatment with auranofin in a patient with elderly-onset Still's disease

We report a successful treatment with auranofin in a case of elderly-onset Still's disease. The administration of non-steroidal anti-inflammatory drugs, mizoribine and prednisolone were not only insufficient to suppress the disease activity but were followed by the development of multiple gastric ulcers and severe osteoporosis. On the contrary, treatment with auranofin, 9 mg per day, was effective enough to maintain the disease inactive without any side effects. We also found that plasma levels of interleukin-6 and tumor necrosis factor-alpha were significantly elevated in our patient, suggesting a possible involvement of inflammatory cytokines in this disease.