A Case Report of Still’s Disease in the Adult

Leila A. Cardoso, Fatima Silva, Joana Paixao, Adriano Rodrigues

Abstract


Adult Still’s disease (ASD) is a rare systemic inflammatory disorder of unknown etiology, typically characterized by a clinical triad (daily spiking high fevers, evanescent rash, and arthritis) and a biological triad (hyperferritinemia, hyperleucocytosis with neutrophilia and abnormal liver function test). There are no specific diagnostic tests for ASD, so the diagnosis of ASD remains one of exclusion and the differential diagnosis may be lengthy. We present a case of an adult-onset Still’s disease with previous admissions for fever of unknown origin with a 2-month history of fever and systemic symptoms. The patient posteriorly presented polyarthralgies and cutaneous rash. The study disclosed anemia, inflammatory markers and hepatic enzymes elevation, and negative serological and immunological studies. The introduction of corticotherapy resolved symptoms and laboratories alterations. Adult-onset Still disease is a heterogeneous and rare disease and the lack of serologic markers as a true gold standard makes diagnosis difficult.




J Med Cases. 2017;8(7):224-226
doi: https://doi.org/10.14740/jmc2847w


Keywords


Adult Still’s disease; Fever; Rash; Hyperferritinemia; Polyarthralgies

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