A case of paraneoplastic syndrome mimicking adult-onset Still's disease.
A 49-year-old woman was admitted to our hospital because of fever of unknown origin. The patient had long-lasting spiking fever, hepatosplenomegaly, pleural effusion, and skin rash. Laboratory tests showed marked leukocytosis and an extremely high serum ferritin level (240 000 ng/ml) accompanied by disseminated intravascular coagulation and hemophagocytic syndrome. Most of the patient's features were compatible with a diagnosis of adult-onset Still's disease (AOSD), the rash, however, was not a typical rheumatoid rash but multiforme erythema. Biopsy of a breast nodule revealed breast cancer, leading us to a diagnosis of paraneoplastic syndrome mimicking AOSD. Although this is a rare disorder, cases resembling the present one have been reported, indicating the importance of including paraneoplastic syndrome in the differential diagnosis of AOSD.
Komano
Yukiko
Y
Department of Medicine and Rheumatology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. y-komano.rheu@tmd.ac.jp
Kubota
Tetsuo
T
Wakabayashi
Shihoko
S
Ochi
Sae
S
Nonomura
Yoshinori
Y
Hagiyama
Hiroyuki
H
Nanki
Toshihiro
T
Kohsaka
Hitoshi
H
Miyasaka
Nobuyuki
N