Jain Ankit, Bodicherla Krishna Priya, Vanaparthy Rachana
Psychiatry & Behavioral Health, Penn State College of Medicine, Hershey, USA.
Psychiatry, Sri Devaraj Urs Medical College, Kolar, IND.
Cureus. 2021 Dec 5;13(12):e20180. doi: 10.7759/cureus.20180. eCollection 2021 Dec.
Adult-onset Still's disease (AOSD) is a rare multisystemic autoinflammatory disease with symptoms, including spiking fever, evanescent rash, arthralgia or arthritis, sore throat, lymphadenopathy, hepatosplenomegaly, and myalgia. The prevalence of anxiety and depressive symptoms in rheumatological diseases is quite high, which impacts social as well as occupational functioning. Depression and anxiety are known to be the most common psychiatric comorbidities in patients with arthritis and other rheumatological disorders. Here, we report the case of an adult white female with AOSD who showed improvement in symptoms of AOSD with monoclonal antibodies and steroids; however, significant worsening of pain along with depression & anxiety were noted. With the use of antidepressant serotonin-norepinephrine reuptake inhibitor (SNRI), specifically duloxetine, our patient was able to experience improvement in depression, anxiety, and pain.
成人斯蒂尔病（AOSD）是一种罕见的多系统自身炎症性疾病，症状包括高热、一过性皮疹、关节痛或关节炎、咽痛、淋巴结病、肝脾肿大和肌痛。风湿性疾病中焦虑和抑郁症状的患病率相当高，这会影响社会和职业功能。已知抑郁和焦虑是关节炎及其他风湿性疾病患者中最常见的精神共病。在此，我们报告一例患有AOSD的成年白人女性病例，该患者使用单克隆抗体和类固醇后AOSD症状有所改善；然而，疼痛显著加重，同时出现抑郁和焦虑。使用抗抑郁药5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI），特别是度洛西汀后，我们的患者在抑郁、焦虑和疼痛方面均有改善。
