title: An unusual manifestation in a patient with adult-onset Still's disease: Minimal glomerular lesion.
abstract: Adult-onset Still's disease (AOSD) is a multisystem inflammatory disease of unknown etiology. It is characterized by arthritis, hectic fever, transient rash and visceral lesions such as pleuropericarditis, lymphadenopathy and hepato splenomegaly. Although kidney involvement may appear in some cases of AOSD, minimal glomerular lesion (MGL) has not been described. We describe a female patient, who presented with multisystemic manifestations, including high spiking fever, arthralgias, striking hyperferritinemia, and proteinuria. Renal biopsy showed classic MGL. A diagnosis of AOSD was made on the basis of Yamaguchi's criteria. The patient was treated with steroids, resulting in remission of the rheumatological condition closely paralleled by remission of proteinuria, thereby strongly suggesting a causative link between AOSD and MGL in this patient. Renal involvement in the AOSD was rarely reported in the literature. MGL may be a cause of unexplained proteinuria in AOSD. In this situation, renal biopsy is necessary to establish a definitive diagnosis.
authors.affiliation: Department of Rheumatology, CHU Hassan II University Hospital, Fez, Morocco.
authors.forename: Imane
authors.initials: I
authors.lastname: El Mezouar
authors.affiliation: Department of Rheumatology, CHU Hassan II University Hospital, Fez, Morocco.
authors.forename: Fatima Zahra
authors.initials: FZ
authors.lastname: Abourazzak
authors.affiliation: Department of Rheumatology, CHU Hassan II University Hospital, Fez, Morocco.
authors.forename: Najoua
authors.initials: N
authors.lastname: Ghani
authors.affiliation: Department of Rheumatology, CHU Hassan II University Hospital, Fez, Morocco.
authors.forename: Taoufik
authors.initials: T
authors.lastname: Harzy
keywords: Kidney involvement; Still’s disease; minimal glomerular lesion; proteinuria