Adult-onset Still’s Disease as a Differential Diagnosis in Prolonged Fever: Diagnosis and Treatment Experience
Adult onset Still’s disease is a rare systemic disease that may involve many organs and may mimick many disease such as infection, autoimmune disease, and also malignancy. The diagnostic approach and treatment strategies have not been well established due to its rarity; however, there are some diagn...
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| Language: | English |
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Interna Publishing
2019-08-01
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| Series: | Acta Medica Indonesiana |
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| Online Access: | https://actamedindones.org/index.php/ijim/article/view/190 |
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| author | Felix F Widjaja Diah Martina Soroy Lardo Suryo Anggoro K Wibowo |
| author_facet | Felix F Widjaja Diah Martina Soroy Lardo Suryo Anggoro K Wibowo |
| author_sort | Felix F Widjaja |
| collection | DOAJ |
| description | Adult onset Still’s disease is a rare systemic disease that may involve many organs and may mimick many disease such as infection, autoimmune disease, and also malignancy. The diagnostic approach and treatment strategies have not been well established due to its rarity; however, there are some diagnostic criteria that may help. We present a case of 36-year old man who experienced high prolonged fever which firstly thought as infection. He also had unilateral wrist and knee joint pain and maculopapular rash. Laboratory examination showed high leukocytes count with elevated polymorphonuclear neutrophil count, high platelet count, high ferritin level, and negative results of many infection markers (typhoid antibody, procalcitonin, malaria test, blood culture, urine culture, IgM pneumonia, ASTO, syphilis test, antiHIV, HBsAg, antiHCV, etc). Chest X-ray, joint X-ray, ultrasonography, and echocardiography showed normal result. The patient was then diagnosed with Adult-onset Still’s disease and received intravenous methylprednisolone and the fever was disappeared in 3 days. Six months later the arthralgia appeared again, methotrexate was administered and the pain was then relieved. |
| format | Article |
| id | doaj-art-1f7da7cb68b8402cb09aa487dd36dd0e |
| institution | Kabale University |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2019-08-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj-art-1f7da7cb68b8402cb09aa487dd36dd0e2025-08-20T03:32:53ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322019-08-01512317Adult-onset Still’s Disease as a Differential Diagnosis in Prolonged Fever: Diagnosis and Treatment ExperienceFelix F Widjaja0Diah Martina1Soroy Lardo2Suryo Anggoro K Wibowo3Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Indonesia Army Central Hospital Gatot Soebroto, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, IndonesiaAdult onset Still’s disease is a rare systemic disease that may involve many organs and may mimick many disease such as infection, autoimmune disease, and also malignancy. The diagnostic approach and treatment strategies have not been well established due to its rarity; however, there are some diagnostic criteria that may help. We present a case of 36-year old man who experienced high prolonged fever which firstly thought as infection. He also had unilateral wrist and knee joint pain and maculopapular rash. Laboratory examination showed high leukocytes count with elevated polymorphonuclear neutrophil count, high platelet count, high ferritin level, and negative results of many infection markers (typhoid antibody, procalcitonin, malaria test, blood culture, urine culture, IgM pneumonia, ASTO, syphilis test, antiHIV, HBsAg, antiHCV, etc). Chest X-ray, joint X-ray, ultrasonography, and echocardiography showed normal result. The patient was then diagnosed with Adult-onset Still’s disease and received intravenous methylprednisolone and the fever was disappeared in 3 days. Six months later the arthralgia appeared again, methotrexate was administered and the pain was then relieved.https://actamedindones.org/index.php/ijim/article/view/190adult onset Still's diseaseprolonged feverdiagnosistreatment |
| spellingShingle | Felix F Widjaja Diah Martina Soroy Lardo Suryo Anggoro K Wibowo Adult-onset Still’s Disease as a Differential Diagnosis in Prolonged Fever: Diagnosis and Treatment Experience Acta Medica Indonesiana adult onset Still's disease prolonged fever diagnosis treatment |
| title | Adult-onset Still’s Disease as a Differential Diagnosis in Prolonged Fever: Diagnosis and Treatment Experience |
| title_full | Adult-onset Still’s Disease as a Differential Diagnosis in Prolonged Fever: Diagnosis and Treatment Experience |
| title_fullStr | Adult-onset Still’s Disease as a Differential Diagnosis in Prolonged Fever: Diagnosis and Treatment Experience |
| title_full_unstemmed | Adult-onset Still’s Disease as a Differential Diagnosis in Prolonged Fever: Diagnosis and Treatment Experience |
| title_short | Adult-onset Still’s Disease as a Differential Diagnosis in Prolonged Fever: Diagnosis and Treatment Experience |
| title_sort | adult onset still s disease as a differential diagnosis in prolonged fever diagnosis and treatment experience |
| topic | adult onset Still's disease prolonged fever diagnosis treatment |
| url | https://actamedindones.org/index.php/ijim/article/view/190 |
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