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Fulltext An unusual presentation of adult onset Still's disease

Ghosal A, Pal RB, Das SK, Das T

Med J Malaysia, 2012 Oct;67(5):532-3.

Adult onset still's disease usually presents with high grade intermittent fever, polyarthritis, salmon pink evanescent rash and hepatosplenomegaly. Pulmonary involvement in the form of pneumonitis, as a presenting feature is very rare. We report a case of a young lady who presented with fever, cough and respiratory distress. Chest X-ray revealed patchy infiltration in left upper lung zone. She was subsequently diagnosed as Adult onset Still's disease. There was no improvement in clinical condition despite five days of antibiotics. On trans-bronchial lung biopsy (TBLB) proved she had interstitial pneumonitis and responded dramatically to steroid treatment.

Matched MeSH terms: Still's Disease, Adult-Onset*

Hyperferritinaemia: An Iron Sword of Autoimmunity

Giemza-Stokłosa J, Islam MA, Kotyla PJ

Curr Pharm Des, 2019;25(27):2909-2918.

PMID: 31686632 DOI: 10.2174/1381612825666190709202804

BACKGROUND: Ferritin is a molecule that plays many roles being the storage for iron, signalling molecule, and modulator of the immune response.

METHODS: Different electronic databases were searched in a non-systematic way to find out the literature of interest.

RESULTS: The level of ferritin rises in many inflammatory conditions including autoimmune disorders. However, in four inflammatory diseases (i.e., adult-onset Still's diseases, macrophage activation syndrome, catastrophic antiphospholipid syndrome, and sepsis), high levels of ferritin are observed suggesting it as a remarkable biomarker and pathological involvement in these diseases. Acting as an acute phase reactant, ferritin is also involved in the cytokine-associated modulator of the immune response as well as a regulator of cytokine synthesis and release which are responsible for the inflammatory storm.

CONCLUSION: This review article presents updated information on the role of ferritin in inflammatory and autoimmune diseases with an emphasis on hyperferritinaemic syndrome.

Matched MeSH terms: Still's Disease, Adult-Onset/blood

Fulltext Adult-onset Still's disease: a case report

Ong PS, Sulaiman W

Oman Med J, 2011 Sep;26(5):e022.

PMID: 28845225 DOI: 10.5001/omj.2011.96

Adult-onset Still's disease (AOSD) is a rare clinical entity with unknown etiology, characterized by arthritis, fever, evanescent rash and other systemic presentations. This report described a 45-year-old male who presented with sore throat, fever, arthritis, evanescent rash, raised liver enzymes and hyperferritinemia. He was diagnosed to have AOSD based on Yamuguchi criteria after the exclusion of other potential diagnoses. The patient partially responded to combined celecoxib and prednisolone. He was also prescribed methotrexate and his symptoms improved.

Matched MeSH terms: Still's Disease, Adult-Onset

Fulltext Refractory adult onset Still's disease

Sulaiman W, Abdullah AC, Tan JTC, Baba S, Karim N

Cureus, 2017 Oct 25;9(10):e1802.

PMID: 29282446 DOI: 10.7759/cureus.1802

It is often a challenge and a dilemma for clinicians encountering patients with pyrexia of unknown origin. Numerous tests performed to determine the underlying cause often give inconclusive results. We present a 52-year-old man with undulating fever for more than 10 months with persistent hyperferritinaemia, and negative immunological and serological markers. Despite corticosteroids, disease modifying anti-rheumatic agents and immune-modulator therapy, he succumbed to the illness. A diagnosis of refractory Adult onset Still's disease complicated by haemophagocytic lymphohistiocytosis was made.

Matched MeSH terms: Still's Disease, Adult-Onset

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