van Guldener C, Nurmohamed S A, van der Horst-Bruinsma I E
Afd. Inwendige Geneeskunde, Academisch Ziekenhuis Vrije Universiteit, MB Amsterdam.
Ned Tijdschr Geneeskd. 2000 Jul 15;144(29):1410-3.
In three patients, two women aged 70 and 19 years and a man aged 33 years with long-lasting fever no diagnosis was made after extensive diagnostic work-up. After exclusion of infectious, malignant and rheumatic diseases, adult-onset Still's disease was diagnosed in all three patients on the basis of clinical and laboratory criteria. Adult-onset Still's disease is an important but less well known cause of fever. Clinically, adult-onset Still's disease is characterized by the triad of fever, skin rash and arthritis/arthralgia. A greatly elevated serum ferritin level proved to be an additional valuable diagnostic clue. Treatment consists of non-steroidal anti-inflammatory drugs, corticosteroids or immunosuppressive agents. The long-term prognosis is usually good, but severe joint destruction may occur. All three patients recovered.
三名患者，两名女性，年龄分别为70岁和19岁，一名男性，33岁，长期发热，经过广泛的诊断检查后仍未确诊。在排除感染性、恶性和风湿性疾病后，根据临床和实验室标准，这三名患者均被诊断为成人斯蒂尔病。成人斯蒂尔病是发热的一个重要但鲜为人知的原因。临床上，成人斯蒂尔病的特征为发热、皮疹和关节炎/关节痛三联征。血清铁蛋白水平大幅升高被证明是另一个有价值的诊断线索。治疗包括使用非甾体抗炎药、皮质类固醇或免疫抑制剂。长期预后通常良好，但可能会发生严重的关节破坏。所有三名患者均康复。
