Journal of Nepal Medical Association (Feb 2020)

Adult-onset Still's Disease: A Case Report

  • Ashok Sapkota,
  • Nirdesh Pokhrel,
  • Jayaram Adhikari,
  • Bishal Shrestha,
  • Yoveen Kumar Yadav

DOI
https://doi.org/10.31729/jnma.4844
Journal volume & issue
Vol. 58, no. 222

Abstract

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Adult-onset Still’s Disease is a rare auto inflammatory disorder of unknown etiology characterized mainly by high spiking fever, arthritis, evanescent rash and lymphadenopathy. It is a form of systemic onset juvenile rheumatoid arthritis that is encountered in adults, typically between 15-25 years and 36-45years. We here describe a 28 years lady with fever, arthritis of multiple large joints, lymphadenopathy and rash, with negative Rheumatoid factor and evidence of past infection with Ebstein-Barr virus and Parvovirus B19. History, examination findings and investigations showed several features consistent with adult-onset Still’s disease along with high ferritin level. After exclusion of probable other diagnosis and use of Yamaguchi criteria, she was diagnosed with adult-onset Still’s disease. All the major and minor criteria of Yamaguchi for diagnosis were met. Her disease responded well with steroid, she achieved remission and is currently under maintenance therapy.

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