{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:07:05Z","timestamp":1755907625212,"version":"3.44.0"},"reference-count":12,"publisher":"SMC Media","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>We report the use of anakinra to treat a case of a 64-year-old man diagnosed with hemophagocytic lymphohistiocytosis (HLH) with neurological involvement. After the administration of intravenous pulse corticosteroid therapy, immunoglobulin, and anakinra, the patient showed neurological recovery. However, the recovery was complicated by the perforation of a pre-existing bowel diverticulum. The effect of anakinra on bowel inflammation has not yet been clearly established. It can potentially augment bowel inflammation and contribute to the risk of bowel perforation associated with the concomitant use of corticosteroids.<\/jats:p>","DOI":"10.12890\/2021_002842","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T10:02:22Z","timestamp":1636970542000},"source":"Crossref","is-referenced-by-count":0,"title":["Bowel Perforation During Haemophagocytic Lymphohistiocytosis Treatment with Corticosteroids and Anakinra"],"prefix":"10.12890","volume":"8","author":[{"given":"Jan","family":"Adamski","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn","family":"J\u00e4schke","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Satakunta Central Hospital, Pori, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuomas","family":"Nieminem","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Satakunta Central Hospital, Pori, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Weigl","sequence":"additional","affiliation":[{"name":"Anaesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2021,10,12]]},"reference":[{"key":"10.12890\/2021_002842_ref1","doi-asserted-by":"crossref","unstructured":"<li>Mehta P, Cron RQ, Hartwell J, Manson JJ, Tattersall RS. Silencing the cytokine storm: the use of intravenous anakinra in haemophagocytic lymphohistiocytosis or macrophage activation syndrome. <em>Lancet Rheumatol<\/em> 2020;<strong>2<\/strong>:e358\u2013e367. <\/li>","DOI":"10.1016\/S2665-9913(20)30096-5"},{"key":"10.12890\/2021_002842_ref2","doi-asserted-by":"crossref","unstructured":"<li>Jagpal A, Curtis JR. Gastrointestinal perforations with biologics in patients with rheumatoid arthritis: implications for clinicians. <em>Drug Saf<\/em> 2018;<strong>41<\/strong>:545\u2013553. <\/li>","DOI":"10.1007\/s40264-018-0639-1"},{"key":"10.12890\/2021_002842_ref3","doi-asserted-by":"crossref","unstructured":"<li>La Ros\u00e9e P, Horne A, Hines M, von Bahr Greenwood T, Machowicz R, Berliner N, et al. Recommendations for the management of hemophagocytic lymphohistiocytosis in adults. <em>Blood<\/em> 2019;<strong>23<\/strong>:2465\u20132477.<\/li>","DOI":"10.1182\/blood.2018894618"},{"key":"10.12890\/2021_002842_ref4","doi-asserted-by":"crossref","unstructured":"<li>Titos-Garc\u00eda A, Aranda-Narv\u00e1ez JM, Romacho-L\u00f3pez L, Gonz\u00e1lez-S\u00e1nchez AJ, Cabrera-Serna I, Santoyo-Santoyo J. Nonoperative management of perforated acute diverticulitis with extraluminal air: results and risk factors of failure. <em>Int J Colorectal Dis<\/em> 2017;<strong>32<\/strong>:1503\u20131507. <\/li>","DOI":"10.1007\/s00384-017-2852-2"},{"key":"10.12890\/2021_002842_ref5","doi-asserted-by":"crossref","unstructured":"<li>Thorisson A, Nikberg M, Andreasson K, Smedh K, Chabok A. Non-operative management of perforated diverticulitis with extraluminal or free air - a retrospective single center cohort study. <em>Scand J Gastroenterol<\/em> 2018;<strong>53<\/strong>:1298\u20131303. <\/li>","DOI":"10.1080\/00365521.2018.1520291"},{"key":"10.12890\/2021_002842_ref6","doi-asserted-by":"crossref","unstructured":"<li>Gravante G, Yahia S. Medical influences, surgical outcomes: role of common medications on the risk of perforation from untreated diverticular disease. <em>World J Gastroenterol<\/em> 2013;<strong>19<\/strong>:5947\u20135952. <\/li>","DOI":"10.3748\/wjg.v19.i36.5947"},{"key":"10.12890\/2021_002842_ref7","doi-asserted-by":"crossref","unstructured":"<li>Kvasnovsky CL, Papagrigoriadis S, Bjarnason I. Increased diverticular complications with nonsteriodal anti-inflammatory drugs and other medications: a systematic review and meta-analysis. <em>Colorectal Dis<\/em> 2014;<strong>16<\/strong>:O189\u2013196. <\/li>","DOI":"10.1111\/codi.12516"},{"key":"10.12890\/2021_002842_ref8","doi-asserted-by":"crossref","unstructured":"<li>Tursi A, Elisei W. Role of inflammation in the pathogenesis of diverticular disease. <em>Mediators Inflamm<\/em> 2019;<strong>2019<\/strong>:8328490. <\/li>","DOI":"10.1155\/2019\/8328490"},{"key":"10.12890\/2021_002842_ref9","doi-asserted-by":"crossref","unstructured":"<li>Bamias G, Arseneau KO, Cominelli F. Cytokines and mucosal immunity. <em>Curr Opin Gastroenterol<\/em> 2014;<strong>30<\/strong>:547\u2013552. <\/li>","DOI":"10.1097\/MOG.0000000000000118"},{"key":"10.12890\/2021_002842_ref10","doi-asserted-by":"crossref","unstructured":"<li>Carter JD, Valeriano J, Vasey FB. Crohn disease worsened by anakinra administration.<em> J Clin Rheumatol<\/em> 2003;<strong>9<\/strong>:276\u2013277. <\/li>","DOI":"10.1097\/01.RHU.0000081265.06408.e4"},{"key":"10.12890\/2021_002842_ref11","doi-asserted-by":"crossref","unstructured":"<li>H\u00fcgle B, Speth F, Haas JP. Inflammatory bowel disease following anti-interleukin-1-treatment in systemic juvenile idiopathic arthritis. <em>Pediatr Rheumatol Online J<\/em> 2017;<strong>15<\/strong>:16. <\/li>","DOI":"10.1186\/s12969-017-0147-3"},{"key":"10.12890\/2021_002842_ref12","doi-asserted-by":"crossref","unstructured":"<li>Verheul HM, Pinedo HM. Possible molecular mechanisms involved in the toxicity of angiogenesis inhibition. <em>Nat Rev Cancer<\/em> 2007;<strong>7<\/strong>:475\u2013485. <\/li>","DOI":"10.1038\/nrc2152"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2842\/2850","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2842\/2851","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2842\/2851","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T12:25:21Z","timestamp":1755865521000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/2842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,12]]},"references-count":12,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.12890\/2021_002842","relation":{"has-manifestation":[{"id-type":"other","id":"1-78-2842-g2850","asserted-by":"subject"},{"id-type":"other","id":"1-78-2842-g2851","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-78","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"type":"electronic","value":"2284-2594"}],"subject":[],"published":{"date-parts":[[2021,10,12]]},"article-number":"10"}}