Stll Disease Is Stll Hard to Diagnosis: A Case Report
Abstract
Adult-onset Still Disease (AOSD) is a rare rheumatologic condition with unrecognized etiology. Spiking fevers, joint involvement (arthralgia or arthritis), rashes, lymphadenopathy, abnormal liver function test data, and leukocytosis are the main features of this disease. Yamaguchi’s criteria with the sensitivity and specificity of 96.2% and 92.1%, respectively, is the most beneficial tool for the diagnosis of AOSD, as a rare disease. The uncommon features of the still disease remain confusing for clinicians. about the present study reported a 27-year-old patient who was referred to our hospital with an unknown diagnosis, because of the rare features of Still disease. The explored characteristics of rashes, fever, and para-clinical data, as well as laboratory and imaging data, are described in detail; such features have led to long hospitalization to confirm the diagnosis in this patient. The positive family history of the rheumatologic disease and dramatic response to low dose corticosteroids were other outstanding features of our case. This report highlighted the necessity of conducting randomized clinical trials to address the management of AOSD. Besides, the present study signified the need for providing further awareness among clinicians to prevent long hospitalization.
[2] Yoshifuku A, Kawai K, Kanekura T. Adult-onset Stll disease with peculiar persistent plaques and papules. Clinical and Experimental Dermatology. 2014; 39(4):503-5. [DOI:10.1111/ced.12335] [PMID]
[3] Fautrel B. Adult-onset stll disease. Best Practce & Research. Clinical Rheumatology. 2008; 22(5):773-92. [DOI:10.1016/j. berh.2008.08.006] [PMID]
[4] Senthilvel E, Papadakis A, McNamara M, Adebambo I. Adultonset Stll Disease (AOSD). Journal of the American Board of Family Medicine: JABFM. 2010; 23(3):418-22. [DOI:10.3122/jabfm.2010.03.090157] [PMID]
[5] Lee JY, Hsu CK, Liu MF, Chao SC. Evanescent and persistent pruritc eruptons of adult-onset stll disease: A clinical and pathologic study of 36 patents. Seminars in Arthrits and Rheumatsm. 2012; 42(3):317-26. [DOI:10.1016/j.semarthrit.2012.05.003] [PMID]
[6] Colina M, Trota F. Clinical predictors in adult-onset stll disease: There is no getng away from ferritn and arthrits. The Journal of Dermatology. 2013; 40(3):234-5. [DOI:10.1111/1346-8138.12033] [PMID]
[7] Jimenez D, Allegret P, Kallal K. Adult stll disease: Worsening inflammatory changes in a 26-year-old woman. The American Journal of Emergency Medicine. 2010; 28(1):114.e1-2. [DOI:10.1016/j. ajem.2009.02.031] [PMID]
[8] Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H, et al. Preliminary criteria for classifcaton of adult Stll’s disease. The Journal of Rheumatology. 1992; 19(3):424-30. [PMID]
[9] Fautrel B, Zing E, Golmard JL, Le Moel G, Bissery A, Rioux C, et al. Proposal for a new set of classifcaton criteria for adult-onset stll disease. Medicine. 2002; 81(3):194-200. [DOI:10.1097/00005792- 200205000-00003] [PMID]
[10] Siddiqui M, Putman MS, Dua AB. Adult-onset Stll’s disease: Current challenges and future prospects. Open Access Rheumatology: Research and Reviews. 2016; 8:17-22. [DOI:10.2147/OARRR. S83948] [PMID] [PMCID]
Files | ||
Issue | Vol 6 No 2 (2021): March-April | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/crcp.v6i2.6677 | |
Keywords | ||
Adult stll disease Fever Diagnosis |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |