Adult onset Still’s disease: a diagnostic challenge

Authors

  • Rahul Jain Department of General Medicine, Grant Govt. Medical College, Mumbai, Maharashtra, India
  • V. K. Joglekar Department of General Medicine, Grant Govt. Medical College, Mumbai, Maharashtra, India
  • Kriti Jain Department of Dermatology, Subharti Medical College, Meerut, UP, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20180119

Keywords:

Fever, Skin rash, Arthralgia, Adult onset Still’s disease

Abstract

Adult Still’s disease (ASD) is a systemic inflammatory disorder of unknown etiology, typically characterized by a clinical triad of daily spiking high fevers, evanescent rash, and arthritis. This report described a 26-year-old male who presented with these symptoms along with raised liver enzymes and hyperferritinemia. After ruling out systemic infections, localized infections, malignancies and other rheumatological diseases, Adult onset Still’s disease diagnosis was made according to Yamaguchi criteria (having 4 major features and 3 minor features). AOSD is a heterogeneous and rare disease and the lack of serologic markers as a true gold standard makes diagnosis difficult.

Metrics

Metrics Loading ...

Author Biography

Rahul Jain, Department of General Medicine, Grant Govt. Medical College, Mumbai, Maharashtra, India

department of Dermatology

Subharti Medical College

References

Petty RE, Southwood TR, Baum J, Bhettay E, Glass DN, Manners P, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. The Journal of rheumatology. 1998;25(10):1991-4.

Bolognia J, Jorizzo J, Schaffer J. Dermatology. 3rd ed. Elsevier Saunders; 2012: 671-675.

Pouchot J, Sampalis JS, Beaudet F, Carette S, DÉcary F, Salusinsky-sternbach M, et al. Adult Still's disease: manifestations, disease course, and outcome in 62 patients. Medicine. 1991;70(2):118-36.

Larson EB. Adult Still's disease—recognition of a clinical syndrome and recent experience. West J Med. 1985;142(5):665–71.

Efthimiou P, Paik PK, Bielory L. Diagnosis and management of adult onset Still’s disease. Ann Rheum Dis. 2006;65(5):564–72.

Kötter I, Wacker A, Koch S, Henes J, Richter C, Engel A, et al. Anakinra in patients with treatment-resistant adult-onset Still’s disease. Semin Arthritis Rheum. 2007;37:189–97.

Puechal X, DeBandt M, Berthelot JM, Breban M, Dubost JJ, Fain O, et al. Tocilizumab in refractory adult Still’s disease. Arthritis Care Res. 2011;63:155–9.

Bleeker-Rovers CP, Vos FJ, de Kleijn EM, Mudde AH, Dofferhoff TS, Richter C, et al. A prospective multicenter study on fever of unknown origin: the yield of a structured diagnostic protocol. Medicine (Baltimore). 2007;86(1):26-38.

Owlia M., Mehrpoor G. Adult onset still’s disease: a review. Indian J Med Sci. 2009;63(5):207–21.

Ichiki H., Shishido M., Nishiyama S. Two cases of adult onset of Still's disease in the elderly. Nippon Ronen Igakkai Zasshi. 1992;29(12):960–4.

Cagatay Y, Gul A, Cagatay A, Kamali S, Karadeniz A, Inanc M, et al. Adult-onset still's disease. Int J Clin Pract. 2009;63(7):1050–5.

Crispin JC, Martinez-Banos D, Alcocer-Varela J. Adult-onset Still disease as the cause of fever of unknown origin. Medicine (Baltimore). 2005;84(6):331-7.

Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H. et al Preliminary criteria for classification of adult Still's disease. J Rheumatol. 1992;19:424–30.

Cush JJ, Medsger TA, Jr, Christy WC, Herbert DC, Cooperstein LA. Adult‐onset Still's disease. Clinical course and outcome. Arthritis Rheum. 1987;30:186–94.

Fautrel B, Zing E, Golmard J L, Le Moel G, Bissery A, Rioux C, et al Proposal for a new set of classification criteria for adult‐onset still disease. Medicine (Baltimore). 2002;81:194–200.

Downloads

Published

2018-01-23