PMC3437612_01
Improvement in flares and the decline of the prednisone dose after initiation of anakinra.
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The patient continued to remain dyspneic and she continued to have flares characterized by fevers, rash, and uncontrolled arthralgias (Figure 1). The patient experienced rapid resolution of her systemic symptoms, and due to the lack of recurrence of her flares, the prednisone was weaned down and stopped within 18 months (Figure 1).
(a) Improvement in 6MWT after anakinra initiation; (b) improvement in RVSP after anakinra initiation. 6MWT: six minute walk test; RVSP : right ventricular systolic pressure.
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She had moderate improvement of her RVSP by echocardiogram, but her functional class and dyspnea continue to worsen with the flares (Figure 2). She also noticed improvement in her effort tolerance which is evidenced in her performance on six-minute walk tests (Figure 2(a)).