Sanada I, Kawano F, Tsukamoto A, Kiyokawa T, Shido T, Koga S
Institute for Clinical Research, Kumamoto National Hospital.
Rinsho Ketsueki. 1997 Nov;38(11):1194-8.
We report a 82-year-old woman with adult onset Still's disease (AOSD), who presented with high fever, skin rash, swollen axillary lymph nodes, accelerated erythrocyte sedimentation rate, leukocytosis, abnormal liver function tests, hypoalbuminemia, negative antinuclear antibody and rheumatoid factor, and lack of renal involvement. Disseminated intravascular coagulation (DIC) was also diagnosed on admission. An antipyretic relieved high fever and DIC soon improved. Three years later, AOSD relapsed accompanied by hypercoagulation and hyperfibrinolysis. The patient developed subdural hematoma and DIC due to a brain contusion. High titers of serum soluble adhesion molecules and soluble thrombomodulin were noted on the first episode of DIC. These findings indicated that endothelial cells were damaged in AOSD complicated by DIC.
我们报告了一名82岁患有成人斯蒂尔病（AOSD）的女性，她表现为高热、皮疹、腋窝淋巴结肿大、红细胞沉降率加快、白细胞增多、肝功能检查异常、低白蛋白血症、抗核抗体和类风湿因子阴性，且无肾脏受累。入院时还诊断出弥散性血管内凝血（DIC）。使用退烧药后高热缓解，DIC也很快改善。三年后，AOSD复发并伴有高凝和高纤溶状态。患者因脑挫伤出现硬膜下血肿和DIC。在DIC的首次发作时发现血清可溶性黏附分子和可溶性血栓调节蛋白水平升高。这些发现表明，在并发DIC的AOSD中内皮细胞受到了损伤。
