[Fever of unknown origin caused by the adult form of Still's disease].
In three patients, two women aged 70 and 19 years and a man aged 33 years with long-lasting fever no diagnosis was made after extensive diagnostic work-up. After exclusion of infectious, malignant and rheumatic diseases, adult-onset Still's disease was diagnosed in all three patients on the basis of clinical and laboratory criteria. Adult-onset Still's disease is an important but less well known cause of fever. Clinically, adult-onset Still's disease is characterized by the triad of fever, skin rash and arthritis/arthralgia. A greatly elevated serum ferritin level proved to be an additional valuable diagnostic clue. Treatment consists of non-steroidal anti-inflammatory drugs, corticosteroids or immunosuppressive agents. The long-term prognosis is usually good, but severe joint destruction may occur. All three patients recovered.
Afd. Inwendige Geneeskunde, Academisch Ziekenhuis Vrije Universiteit, MB Amsterdam.
C
C
van Guldener
S A
SA
Nurmohamed
I E
IE
van der Horst-Bruinsma
D000328:Adult; D000368:Aged; D001168:Arthritis / Q000209:etiology; D003937:Diagnosis, Differential; D004890:Erythema / Q000209:etiology; D005260:Female; D005293:Ferritins / Q000097:blood; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D008297:Male; D016706:Still's Disease, Adult-Onset / Q000097:blood / Q000150:complications* / Q000175:diagnosis*
D005293:Ferritins