Complete regression of hip structural damage with anakinra: a case report

Systemic juvenile idiopathic arthritis (SJIA) is an autoinflammatory rheumatic disease characterized by the presence of intermittent spiking fever, evanescent erythematous rash, arthritis, lymphadenopathy, hepatosplenomegaly, serositis and elevated inflammatory markers. It accounts for only 10-20% of all patients with JIA but is associated with higher morbidity and mortality. Despite the variety of treatments available, in some cases the disease is difficult to control and has a refractory course. The recent knowledge of the key role of certain cytokines (interleukin (IL)-1, IL-6 and IL-18) in its pathogenesis makes them potential therapeutic targets. Anakinra is a recombinant form of human IL-1 receptor antagonist (IL-1Ra) that has been used in SJIA refractory cases and as first line therapeutic agent in selected patients.