Yaman Feride, Kimiaei Ali
Department of Pulmonology Bahcesehir University School of Medicine İstanbul Turkey.
Bahcesehir University School of Medicine İstanbul Turkey.
Clin Case Rep. 2023 Aug 21;11(8):e7510. doi: 10.1002/ccr3.7510. eCollection 2023 Aug.
Adult-onset Still's disease is a rare inflammatory condition with diverse clinical features. Yamaguchi criteria aid diagnosis, and pleural effusion and elevated ferritin levels are important markers. Steroids are the first-line treatment.
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory condition with an unknown etiology. It is characterized by, spiking fever, arthritis, evanescent rash, sore throat, serositis, hepatomegaly, splenomegaly, and lymphadenopathy. It is a diagnosis of exclusion and has infections, systemic autoimmune and inflammatory rheumatic diseases, malignancy, and adverse drug reactions as its differential diagnosis. Because of these characteristics, diagnosis is frequently delayed, posing a significant challenge for physicians. While several classification criteria can be used to diagnose Still's disease, they have limitations in terms of sensitivity and specificity. The Yamaguchi criteria are considered the most sensitive and commonly used, requiring the presence of at least five characteristics, with at least two being major diagnostic criteria. Steroid therapy is the first-line treatment for AOSD patients. In this case report, we present a 56-year-old female patient who developed pleurisy a few months after a car accident, subsequently diagnosed with adult-onset Still's disease.
成人斯蒂尔病是一种罕见的炎症性疾病,具有多种临床特征。山口标准有助于诊断,胸腔积液和铁蛋白水平升高是重要标志物。类固醇是一线治疗药物。
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。其特征为高热、关节炎、一过性皮疹、咽痛、浆膜炎、肝肿大、脾肿大和淋巴结病。它是一种排除性诊断,其鉴别诊断包括感染、全身性自身免疫性和炎症性风湿性疾病、恶性肿瘤及药物不良反应。由于这些特点,诊断常常延迟,给医生带来重大挑战。虽然有几种分类标准可用于诊断斯蒂尔病,但它们在敏感性和特异性方面存在局限性。山口标准被认为是最敏感且最常用的,要求至少具备五个特征,其中至少两个为主要诊断标准。类固醇疗法是AOSD患者的一线治疗方法。在本病例报告中,我们介绍了一名56岁女性患者,她在车祸后数月出现胸膜炎,随后被诊断为成人斯蒂尔病。