Febrile infection-related epilepsy syndrome treated with anakinra.

Kenney-Jung, Daniel L; Vezzani, Annamaria; Kahoud, Robert J; LaFrance-Corey, Reghann G; Ho, Mai-Lan; Muskardin, Theresa Wampler; Wirrell, Elaine C; Howe, Charles L et al. · Ann Neurol · 2016

case_report · Level V

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Abstract

Febrile infection-related epilepsy syndrome (FIRES) is a devastating epileptic encephalopathy with limited treatment options and an unclear etiology. Anakinra is a recombinant version of the human interleukin-1 receptor antagonist used to treat autoinflammatory disorders. This is the first report of anakinra for treatment of a child with super-refractory status epilepticus secondary to FIRES. Anakinra was well tolerated and effective. Cerebral spinal fluid analysis revealed elevated levels of proinflammatory cytokines before treatment that normalized on anakinra, suggesting a potential pathogenic role for neuroinflammation in FIRES. Further studies are required to assess anakinra efficacy and dosing, and to further delineate disease etiology. Ann Neurol 2016;80:939-945.

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