Izumikawa Kinichi, Morinaga Yoshitomo, Kondo Akira, Hara Kohei, Izumikawa Koichi, Miyazaki Yoshitsugu, Kohno Shigeru, Igari Narihiko, Akaboshi Mana, Kawakami Jun, Eguchi Katsumi
Izumikawa Hospital, 2405 Fukae-cho, Minami-shimabara, Nagasaki, 859-1504 Japan.
J Infect Chemother. 2007 Apr;13(2):114-7. doi: 10.1007/s10156-007-0503-1. Epub 2007 May 8.
A 77-year-old woman was admitted to our hospital complaining of high fever. The physical examination on admission indicated no abnormality. Although several antibiotics were administered, the spiking high fever was not alleviated. Two weeks after admission a macular rash appeared, and a high concentration of serum ferritin was observed. At this point, Still's disease was suspected, and the patient was referred to Nagasaki University Hospital. During the prescribed course of prednisolone, hepatic enzymes gradually increased to high titers accompanied by a positive test for cytomegalovirus (CMV) antigen. The CMV antigen disappeared after ganciclovir administration, and the concentration of serum ferritin decreased after steroid administration. In this report, we attempt to portray the relation between the pathogenesis of adult-onset Still's disease and the presence of CMV antigen.
一名77岁女性因高热入院。入院时体格检查未发现异常。尽管使用了多种抗生素，但高热并未缓解。入院两周后出现斑疹，且血清铁蛋白浓度升高。此时怀疑为斯蒂尔病，患者被转诊至长崎大学医院。在规定的泼尼松龙疗程中，肝酶逐渐升高至高滴度，同时巨细胞病毒（CMV）抗原检测呈阳性。给予更昔洛韦后CMV抗原消失，给予类固醇后血清铁蛋白浓度降低。在本报告中，我们试图描述成人斯蒂尔病的发病机制与CMV抗原存在之间的关系。
