Department of Internal Medicine, Gaziantep University, School of Medicine, Gaziantep, Turkey.
Clin Rheumatol. 2010 Apr;29(4):423-6. doi: 10.1007/s10067-009-1331-8. Epub 2010 Jan 26.
Adult onset Still's Disease (ASD) is a systemic inflammatory disorder of unknown etiology characterized by chronic and fluctuant fever with accompanying rash, polyarthritis and involvement of multiple organs, especially lymphoid tissues. Although kidney involvement may appear in some cases of adult Still's disease, membranous glomerulonephyritis has not been described before. We herein report a 38-year-old man diagnosed with Still's disease with longstanding polyarthritis unresponsive to high-dose steroids and various immunosuppressive drugs for 5 years. He was referred to our clinic with bilateral pretibial edema on his legs. Urine examination revealed 10.5 g/day proteinuria with membranous glomerulonephritis and his renal biopsy came up with it. Infliximab was initiated, and his complaints were totally resolved also with a normal urine test in the following 3 months. To the best of our knowledge, this is the first report that clearly shows the efficacy of infliximab in a patient with refractory ASD with membranous glomerulonephyritis.
成人斯蒂尔病（ASD）是一种病因不明的系统性炎症性疾病，其特征为慢性和波动性发热，伴有皮疹、多发性关节炎和多器官受累，特别是淋巴组织。尽管肾脏受累在某些成人斯蒂尔病病例中可能出现，但以前没有描述过膜性肾小球肾炎。我们在此报告一例 38 岁男性，患有斯蒂尔病，长期多关节炎，对大剂量类固醇和各种免疫抑制剂治疗 5 年无反应。他因双侧小腿胫骨前水肿而被转至我们诊所。尿液检查显示蛋白尿 10.5g/天，伴有膜性肾小球肾炎，其肾活检结果也证实了这一点。给予英夫利昔单抗治疗，在接下来的 3 个月中，他的症状完全缓解，尿液检查也恢复正常。据我们所知，这是首例明确显示英夫利昔单抗在难治性伴有膜性肾小球肾炎的 ASD 患者中的疗效的报告。
