Department of Rheumatology, Fukushima Medical University School of Medicine, Japan.
Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Japan.
Intern Med. 2023 Oct 1;62(19):2901-2906. doi: 10.2169/internalmedicine.1026-22. Epub 2023 Feb 22.
Adult-onset Still's disease (AOSD) is characterized by high spiking fever, evanescent rash, and arthritis. However, AOSD rarely presents with severe acute kidney injury (AKI). We herein present the case of a 56-year-old woman with new-onset AOSD who rapidly developed AKI. A physical examination and laboratory data revealed spiking fever, evanescent rash, thrombocytopenia, hyperferritinemia, and azotemia. The patient was diagnosed with AOSD complicated by AKI and macrophage activation syndrome. Treatment with high-dose steroids, hemodialysis, and plasma exchange successfully resolved her AKI. In this report, we review previously published reports on AOSD accompanied by AKI and discuss this rare complication in AOSD.
成人Still 病(AOSD)的特征为高热、一过性皮疹和关节炎。然而,AOSD 很少出现严重的急性肾损伤(AKI)。本文报告了一例新发 AOSD 的 56 岁女性患者,其迅速发生 AKI。体格检查和实验室数据显示高热、一过性皮疹、血小板减少、高铁蛋白血症和氮质血症。该患者被诊断为并发 AKI 和巨噬细胞活化综合征的 AOSD。高剂量类固醇、血液透析和血浆置换治疗成功解决了她的 AKI。在本报告中,我们回顾了之前发表的伴有 AKI 的 AOSD 报告,并讨论了 AOSD 中这一罕见并发症。