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. 2020 Jun 26;11:939. doi: 10.3389/fphar.2020.00939

Figure 2.

Figure 2

Patient's CsA level, IL-2, and ESR/CRP levels monitoring during the time. Etanercept interruption has led to cytokine level fluctuations and clinically unexpected CsA trough levels. The initiation of etanercept has induced a steep decline of IL-2, ESR and CRP levels due to inflammation resolution. Initiation of CsA overlapped with the decline. As a result, the first three CsA level results were lower than the measurement range of applied immunoassay. From day 225 to day 367, CsA trough levels slowly increased to 79.7 ng/ml with co-administration of diltiazem and under more stable cytokine levels. Day 0 set as the first day of CsA administration. Plotted CsA level results were measured with chemiluminescent magnetic microparticle immunoassay by hospital laboratory. Results below measurement range were taken as 15 ng/ml (half of assay lower detection limit). Csa, cyclosporine; ecp, etanercept; ESR, erythrocyte sedimentation rate; CRP, Creactive protein. Applied unit for CRP is mg/ml, for ESR is mm/h.