Awad Jamal, Farah Raymond, Horn Ivona
Internal Medicine A Department, Western Galilee Hospital, Nahariya, Israel.
Eur J Intern Med. 2007 Mar;18(2):155-7. doi: 10.1016/j.ejim.2006.07.025.
We report the case of a 60-year-old woman who had recently been examined for fever of unknown origin and who presented to our hospital with high fever and myalgia, weakness, sore throat, and rash. The patient had a markedly elevated serum ferritin concentration of 40,000 ng/mL and positive antinuclear antibodies (ANA) with a titer of 1/200. Despite the presence of positive ANA, the patient was diagnosed as having adult Still's disease (ASD). High-dose steroid therapy resulted in a remarkable clinical improvement. Such a severe case of systemic inflammatory response syndrome, masquerading as sepsis with a positive ANA test, has not been reported previously, at least not in the last 15 years.
我们报告了一例60岁女性病例,该患者近期因不明原因发热接受检查,随后因高热、肌痛、乏力、咽痛和皮疹前来我院就诊。患者血清铁蛋白浓度显著升高,达40,000 ng/mL,抗核抗体(ANA)阳性,滴度为1/200。尽管ANA阳性,但该患者仍被诊断为成人斯蒂尔病(ASD)。大剂量类固醇治疗使临床症状显著改善。这种伪装成脓毒症且ANA检测呈阳性的严重全身炎症反应综合征病例,此前至少在过去15年中未见报道。