Paul Mishouri, Paul Prodip, Dey Dipon, Safdar Saba, Ramos Julio
Medicine, Interfaith Medical Center, New York, USA.
Internal Medicine, Geisinger Community Medical Center, Scranton, USA.
Cureus. 2021 Jul 4;13(7):e16163. doi: 10.7759/cureus.16163. eCollection 2021 Jul.
Adult-onset Still's disease (AOSD), a rare systemic inflammatory disorder of unknown etiology, is considered in broad differential in patients with fever of unknown origin or unexplained lymphadenopathy. It is characterized by spiking fever, evanescent salmon-colored maculopapular rash, arthritis or arthralgia, and leukocytosis. Due to broad differentials and lack of any specific diagnostic tests, diagnosis of AOSD poses a great challenge. A concerned physician should have a high index of suspicion while dealing with patients presenting with clinical symptoms of this systemic disorder. We report a case of a 25-year-old African American female with the past medical history of AOSD, who presented with four weeks history of extensive cervical and axillary lymphadenopathy mimicking lymphoproliferative malignancy. Cases have been reported with the development of malignant lymphoma during the course of AOSD. Therefore, careful monitoring of patients with regular follow-up is vital as these patients may develop lymphoproliferative malignancy in the future.
成人斯蒂尔病(AOSD)是一种病因不明的罕见全身性炎症性疾病,在不明原因发热或不明原因淋巴结病的患者鉴别诊断中需广泛考虑。其特征为高热、一过性的鲑鱼色斑丘疹、关节炎或关节痛以及白细胞增多。由于鉴别诊断范围广泛且缺乏任何特异性诊断试验,AOSD的诊断极具挑战性。在诊治出现这种全身性疾病临床症状的患者时,相关医生应保持高度怀疑。我们报告一例25岁非裔美国女性,既往有AOSD病史,此次因广泛的颈部和腋窝淋巴结病长达四周就诊,酷似淋巴增殖性恶性肿瘤。已有报道称在AOSD病程中会发生恶性淋巴瘤。因此,对这些患者进行定期随访的仔细监测至关重要,因为他们未来可能会发生淋巴增殖性恶性肿瘤。