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...

Full description

Saved in:
Bibliographic Details
Main Authors: Felix F Widjaja, Diah Martina, Soroy Lardo, Suryo Anggoro K Wibowo
Format: Article
Language:English
Published: Interna Publishing 2019-08-01
Series:Acta Medica Indonesiana
Subjects:
Online Access:https://actamedindones.org/index.php/ijim/article/view/190
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849417323389124608
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
work_keys_str_mv AT felixfwidjaja adultonsetstillsdiseaseasadifferentialdiagnosisinprolongedfeverdiagnosisandtreatmentexperience
AT diahmartina adultonsetstillsdiseaseasadifferentialdiagnosisinprolongedfeverdiagnosisandtreatmentexperience
AT soroylardo adultonsetstillsdiseaseasadifferentialdiagnosisinprolongedfeverdiagnosisandtreatmentexperience
AT suryoanggorokwibowo adultonsetstillsdiseaseasadifferentialdiagnosisinprolongedfeverdiagnosisandtreatmentexperience