Agha-Abbaslou Mojgan, Bensaci Ana Maria, Dike Oluchi, Poznansky Mark C, Hyat Arooj
Division of Infectious Disease, Department of Medicine, Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA.
Division of Infectious Disease, Department of Medicine, Salem Hospital, North Shore Medical Center, Salem, MA, USA.
Am J Case Rep. 2017 Feb 3;18:119-124. doi: 10.12659/ajcr.901846.
BACKGROUND Adult-onset Still's Disease (AOSD) is a rare systemic inflammatory disease accompanied by a triad of spiking fever, maculopapular exanthema, and arthralgia. To date, there is no definite laboratory or imaging test available for diagnosing AOSD, and the diagnosis is one of exclusion, which can be very challenging. CASE REPORT We report on the case of a 53-year-old female who presented with fever, arthralgia, and abdominal pain. Her initial laboratory tests showed elevated AST and ALT, and normal leukocytes with bandemia. During her hospitalization, we evaluated the patient for other potential differential diagnoses. After an extensive workup, the patient was diagnosed with AOSD based on Yamaguchi criteria. Her serum ferritin levels were measured and found to be markedly elevated, which is a non-specific finding in AOSD patients. CONCLUSIONS This case highlights the important role of a detailed history and physical examination for timely diagnosis of AOSD to prevent complications and improve patient's prognosis.
背景 成人斯蒂尔病（AOSD）是一种罕见的全身性炎症性疾病，伴有高热、斑丘疹和关节痛三联征。迄今为止，尚无明确的实验室或影像学检查可用于诊断AOSD，其诊断是排除性诊断之一，可能极具挑战性。病例报告 我们报告一例53岁女性患者，其表现为发热、关节痛和腹痛。她最初的实验室检查显示AST和ALT升高，白细胞正常但有核左移。在她住院期间，我们对患者进行了其他潜在鉴别诊断的评估。经过全面检查，根据山口标准该患者被诊断为AOSD。测量了她的血清铁蛋白水平，发现明显升高，这在AOSD患者中是一个非特异性发现。结论 该病例强调了详细病史和体格检查对及时诊断AOSD以预防并发症和改善患者预后的重要作用。
