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老年患者以无菌性脑膜炎为首发症状的成人斯蒂尔病。

Adult-onset Still's disease presenting with aseptic meningitis as the first symptom in an elderly patient.

作者信息

Ito Naohito, Takahashi Makoto, Miwa Yusuke, Kagami Shinji, Hayakawa Hiroshi, Inaba Akira, Orimo Satoshi

机构信息

Department of Neurology, Kanto Central Hospital, Tokyo, Japan.

Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.

出版信息

eNeurologicalSci. 2019 Aug 12;16:100202. doi: 10.1016/j.ensci.2019.100202. eCollection 2019 Sep.

DOI:10.1016/j.ensci.2019.100202
PMID:31485491
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6715887/
Abstract

•Neutrophilic meningitis is rarely observed in Adult onset Still's disease (AOSD).•AOSD-related meningitis has been observed in the AOSD course of young adults.•An elderly man showed neutrophilic meningitis as a first symptom of AOSD.•First-line therapy with steroid for bacterial meningitis complicated the diagnosis.•Hyperferritinemia led to the correct diagnosis of AOSD and AOSD-related meningitis.

摘要

•成人斯蒂尔病（AOSD）中很少观察到嗜中性粒细胞性脑膜炎。

•在年轻成人的AOSD病程中观察到与AOSD相关的脑膜炎。

•一名老年男性表现出嗜中性粒细胞性脑膜炎作为AOSD的首发症状。

•针对细菌性脑膜炎的一线类固醇治疗使诊断复杂化。

•高铁蛋白血症导致了AOSD及与AOSD相关脑膜炎的正确诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9075/6715887/2578ab505113/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9075/6715887/2578ab505113/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9075/6715887/2578ab505113/gr1.jpg

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本文引用的文献

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Reversible posterior leukoencephalopathy syndrome in a case of adult onset Still's disease with concurrent thrombotic thrombocytopenic purpura: response to high dose immunoglobulin infusions.成人斯蒂尔病合并血栓性血小板减少性紫癜患者的可逆性后部白质脑病综合征：对大剂量免疫球蛋白输注的反应
J Assoc Physicians India. 2012 Nov;60:59-62.
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Adult-onset Still's disease: a review.成人斯蒂尔病：综述
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Diagnostic value of procalcitonin measurement in febrile patients with systemic autoimmune diseases.降钙素原检测在全身性自身免疫性疾病发热患者中的诊断价值。
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Miller Fisher syndrome in adult onset Still's disease: case report and review of the literature of other neurological manifestations.成人斯蒂尔病合并米勒-费雪综合征：病例报告及其他神经学表现的文献综述
Rheumatology (Oxford). 2002 Feb;41(2):216-22. doi: 10.1093/rheumatology/41.2.216.
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Still's disease can cause neutrophilic meningitis.斯蒂尔病可引起嗜中性粒细胞性脑膜炎。
Neurology. 2000 Mar 14;54(5):1203-5. doi: 10.1212/wnl.54.5.1203.
6
Adult onset Still's disease presenting as aseptic meningitis in a young healthy female.一名年轻健康女性患成人斯蒂尔病，表现为无菌性脑膜炎。
Del Med J. 1999 Apr;71(4):181-4.
7
Aseptic meningitis and focal central nervous system involvement in a case of adult onset Still's disease.一例成人斯蒂尔病患者出现无菌性脑膜炎和局灶性中枢神经系统受累
J Rheumatol. 1993 Apr;20(4):765-7.
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Adult Still's disease: a multicenter survey of Japanese patients.成人斯蒂尔病：日本患者的多中心调查
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9
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Medicine (Baltimore). 1991 Mar;70(2):118-36.
10
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J Rheumatol. 1992 Mar;19(3):424-30.