title: Granulomas Formation in Lymph Nodes, Liver and Spleen in Adult-Onset Still's Disease: A Case Report.
abstract: Tissue granulomas formation in adult-onset Still's disease (AOSD) is extremely rare. We describe a case of AOSD associated with formation of granulomatous lesions in lymph nodes, liver and presumably spleen. The high dose steroid-dependent nature of our patient's illness, characterized by disease relapses when methylprednisolone dose was reduced below 10 mg/d, was overwhelmed with institution of anakinra (100 mg/d). The histologic finding of granulomas formation in lymph nodes, liver or spleen should not deter the consideration of AOSD as a potential diagnosis in a compatible clinical context; however, other more common etiologies of tissue granulomas formation should be first excluded.
authors.affiliation: Department of Internal Medicine, University Hospital of Patras, Rion-Patras 26504, Greece.
authors.forename: Stelios F
authors.initials: SF
authors.lastname: Assimakopoulos
authors.forename: Vassilios
authors.initials: V
authors.lastname: Karamouzos
authors.forename: Christos
authors.initials: C
authors.lastname: Papakonstantinou
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Zolota
authors.forename: Chryssoula
authors.initials: C
authors.lastname: Labropoulou-Karatza
authors.forename: Charalambos
authors.initials: C
authors.lastname: Gogos
keywords: Adult-onset Still’s disease; Anakinra; Granulomatous; Hepatic granulomas; Lymphadenitis