Efficacy of Il-1β blockade in refractory aseptic abscesses syndrome

Successful targeted cytokine blockade in a case of aseptic abscess syndrome

“…Our findings confirm the results of previous studies that reported increased IL-6 levels and normal IL-1β plasma levels in AA [5][6][7][8][9]. Instead, increased IL-1β expression was found in inflamed tissues of AA patients irrespective of plasma levels [5,8,10].…”

“…Based on reported evidence for the effectiveness of interleukin 1 receptor antagonists (IL-1RA) in AA, a role for IL-1β was also plausible for our patient [5]. However, treatment with anakinra resulted in a decrease of inflammation markers (Figure 3), but only a temporary improvement of cutaneous lesions; after three months of treatment she still experienced recurrent relapses.…”

“…Instead, increased IL-1β expression was found in inflamed tissues of AA patients irrespective of plasma levels [5,8,10]. This led to the hypothesis that plasma cytokine levels may not reliably reflect the in vivo situation or disease activity, respectively [5,8]. Our patient presented with normal plasma IL-1β and had a partial response to IL-1RA, suggesting only a minor role of IL-1β in this case.…”

“…Aseptic abscess is an emerging entity with defined clinical and histological features [12,13]. An aseptic abscess commonly affects young adults, especially those with an inflammatory bowel disease [5][6][7][8]12]. Aseptic abscess patients present with recurrent sterile abscesses accompanied by abdominal pain, fever and elevation of inflammatory markers [7,8].…”

Unusual neurologic presentation of aseptic abscesses syndrome

“… 1 , 2 Extensive microbiologic workups remain negative, and antibiotics fail to cure patients but relapses can be prevented by corticosteroids and immunosuppressive drugs such as TNF-α antagonists or IL-1 receptor antagonists. 1 , 3 There is no specific feature to distinguish a septic from an aseptic abscess on MRI, although it would be helpful in establishing the diagnosis and eventually preventing the need for biopsies.…”