Login Register Cart 0
Generic placeholder image

Current Rheumatology Reviews

Editor-in-Chief

ISSN (Print): 1573-3971
ISSN (Online): 1875-6360

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Case Report

Case Report on Pulmonary Involvement in a Patient with Adult Still’s Disease

Author(s): Leonid Dvoretsky, Anna Torgashina, Svetlana Rachina*, Nelli Dubrovskaya and Girindu Hewathanthirige

Volume 19, Issue 1, 2023

Published on: 05 August, 2022

Page: [108 - 112] Pages: 5

DOI: 10.2174/1573397118666220527142236

Price: $65

Abstract

Background: Pulmonary manifestations and lung impairment are rarely associated with the Adult Still's Disease and are reported in less than 5%.

Case Presentation: The present clinical case describes the Adult Still's Disease with pulmonary involvement in a 45- year-old male. The main clinical manifestations included continuous fever, failure to respond to antibiotic therapy, skin rashes, musculoskeletal syndrome and pharyngitis. Additionally, bronchopulmonary lymphadenopathy, interstitial changes and dense foci with clear contours were detected in the lungs. Laboratory abnormalities included neutrophilic leukocytosis, increased ALT, AST, and elevated serum inflammatory marker levels. A cyclical course characterised the disease with strictly defined time intervals between flare-ups and remissions. After the prescription of methylprednisolone with the subsequent addition of methotrexate, complete regression of clinical symptoms, normalization of laboratory tests, and partial regression of computed tomography findings in the lungs were observed.

Conclusion: Despite the low incidence, pulmonary involvement is an unfavorable manifestation of Adult Still's Disease. An individual feature of this case report was the asymptomatic lung involvement manifested only by changes revealed through computed tomography. For a long time, flareups of the disease were considered bacterial infections of unclear nature requiring systemic antibiotics.

Keywords: Adult Still's Disease, lymphadenopathy, fever, pulmonary involvement, musculoskeletal syndrome, pharyngitis.

« Previous Next »
Graphical Abstract

[1]
Yamaguchi M, Ohta A, Tsunematsu T, et al. Preliminary criteria for classification of adult Still’s disease. J Rheumatol 1992; 19(3): 424-30.
[PMID: 1578458]
[2]
Fautrel B, Zing E, Golmard J-L, et al. Proposal for a new set of classification criteria for adult-onset still disease. Medicine (Baltimore) 2002; 81(3): 194-200.
[http://dx.doi.org/10.1097/00005792-200205000-00003] [PMID: 11997716]
[3]
Tomaras S, Goetzke CC, Kallinich T, Feist E. Adult-onset still’s disease: Clinical aspects and therapeutic approach. J Clin Med 2021; 10(4): 733.
[http://dx.doi.org/10.3390/jcm10040733] [PMID: 33673234]
[4]
Giacomelli R, Ruscitti P, Shoenfeld Y. A comprehensive review on adult onset Still’s disease. J Autoimmun 2018; 93: 24-36.
[http://dx.doi.org/10.1016/j.jaut.2018.07.018] [PMID: 30077425]
[5]
Gerfaud-Valentin M, Cottin V, Jamilloux Y, et al. Parenchymal lung involvement in adult-onset Still disease A STROBE-compliant case series and literature review. Medicine 2016; 95(30): e4258.
[http://dx.doi.org/10.1097/MD.0000000000004258]
[6]
Ruscitti P, Berardicurti O, Iacono D, et al. Parenchymal lung disease in adult onset Still’s disease: An emergent marker of disease severity-characterisation and predictive factors from Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort of patients. Arthritis Res Ther 2020; 22(1): 151.
[http://dx.doi.org/10.1186/s13075-020-02245-5] [PMID: 32571407]
[7]
Ruscitti P, Cipriani P, Masedu F, et al. Adult-onset Still’s disease: Evaluation of prognostic tools and validation of the systemic score by analysis of 100 cases from three centers. BMC Med 2016; 14(1): 194.
[http://dx.doi.org/10.1186/s12916-016-0738-8] [PMID: 27903264]
[8]
Grom AA, Horne A, De Benedetti F. Macrophage activation syndrome in the era of biologic therapy. Nat Rev Rheumatol 2016; 12(5): 259-68.
[http://dx.doi.org/10.1038/nrrheum.2015.179] [PMID: 27009539]
[9]
Ibn Yacoub Y, Amine B, Hajjaj-Hassouni N. A case of adult-onset Still’s disease complicated with atypical pulmonary defect. Rheumatol Int 2011; 31(2): 239-42.
[http://dx.doi.org/10.1007/s00296-009-1181-3] [PMID: 19809819]

Rights & Permissions Print Cite
Article Metrics
1
© 2024 Bentham Science Publishers | Privacy Policy