Anakinra for Tocilizumab-Refractory Febrile Infection-Related Epilepsy Syndrome (FIRES) with Normal IL-1β Levels: A Case Report - Takeaways - MDSpire

Anakinra for Tocilizumab-Refractory Febrile Infection-Related Epilepsy Syndrome (FIRES) with Normal IL-1β Levels: A Case Report

  • By

  • Zhang, Lijun

  • Li, Deyuan

  • Wang, Jianjun

  • Wang, Xiao

  • Zhao, Wanling

  • Lu, Guoyan

  • June 1, 2026

  • 0 min

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  • 1

    Febrile infection-related epilepsy syndrome (FIRES) is a severe condition with limited treatment options and significant neuroinflammation.

  • 2

    A 6-year-old boy with FIRES developed super-refractory status epilepticus after influenza A infection and failed multiple treatments.

  • 3

    Initial treatment with tocilizumab showed temporary improvement, but seizures relapsed, highlighting the need for alternative therapies.

  • 4

    Switching to anakinra, an IL-1 receptor antagonist, resulted in rapid seizure control within five days in this case.

  • 5

    Anakinra may be a viable second-line treatment for tocilizumab-refractory FIRES, even with normal IL-1β levels.

Original Source(s)

Anakinra for Tocilizumab-Refractory Febrile Infection-Related Epilepsy Syndrome (FIRES) with Normal IL-1β Levels: A Case Report

  • by Zhang, Lijun , Li, Deyuan , Wang, Jianjun , Wang, Xiao , Zhao, Wanling , Lu, Guoyan

  • June 1, 2026

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