Hong Young Hoon, Lee Choong Ki
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea.
Rheumatol Int. 2008 Jul;28(9):931-3. doi: 10.1007/s00296-008-0549-0. Epub 2008 Feb 29.
Prolonged spiking fever, an evanescent salmon-colored rash, arthralgia or arthritis, leukocytosis and organ dysfunction are characteristic of adult onset Still's disease (AOSD). A 25-year-old woman with fever lasting over 3 weeks presented to our clinic. The patient had a spiking fever, sore throat, tender lymph nodes, a fine pink-colored skin rash, arthralgia, myalgia with a high ESR, ferritin and elevated hepatic enzymes. NSAID and prednisolone were prescribed for AOSD with SIRS. After 4 days of therapy, with mild confusion, the patient went into status epilepticus lasting several hours and died after cardiovascular collapse. There has been only one case of status epilepticus associated with AOSD in the medical literature. Here we report a case of AOSD with SIRS complicated by fatal status epilepticus.
持续性高热、一过性鲑鱼色皮疹、关节痛或关节炎、白细胞增多及器官功能障碍是成人斯蒂尔病(AOSD)的特征。一名发热持续超过3周的25岁女性前来我院就诊。该患者有高热、咽痛、压痛性淋巴结、细小粉红色皮疹、关节痛、肌痛,血沉、铁蛋白升高及肝酶升高。给予非甾体抗炎药和泼尼松龙治疗AOSD伴全身炎症反应综合征(SIRS)。治疗4天后,患者出现轻度意识模糊,继而发生持续数小时的癫痫持续状态,最终在心血管衰竭后死亡。医学文献中仅有1例癫痫持续状态与AOSD相关的报道。在此,我们报告1例AOSD伴SIRS并发致命性癫痫持续状态的病例。