Fever of unknown origin as a form of presentation of an adult-onset Still's disease

Authors

Keywords:

adult-onset Still's disease, fever of unknown origin, hyperferritinemia.

Abstract

Introduction: Adult Still's disease is a rheumatic, inflammatory, systemic and chronic disease whose prevalence in the Caucasian population is estimated at 1 case per 100,000 adults.
Objective: To present a young adult patient with a fever of unknown origin as the presentation of adult Still's disease.
Clinical case: 29-year-old patient with a history of rheumatic fever, with a previous hospital admission; who presented a non-infectious febrile illness lasting 50 days, for which the cause was not determined. A year later, the fever reappeared, with similar characteristics, associated with polyarthralgia, hepatosplenomegaly, anemia, hyperferritinemia, neutrophilia, negative rheumatoid factor, and pericarditis was noted during admission. The diagnosis of adult Still's disease was made by exclusion. Treatment with steroids was started, the fever disappeared in the first 24 hours and the patient had a favorable evolution.
Conclusions: Adult Still's disease can present as a fever of unknown origin and is diagnosed by exclusion, since there are no pathognomonic clinical manifestations or laboratory tests. Hyperferritinemia is useful for diagnostic suspicion.

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Author Biographies

Jorge Carlos Castillo Miranda, Hospital finlay

Jefe de especialidad del servicio de medicina interna del hospital Finlay

Xidix Toirac Cabrera, Hospital Finlay

Especialista de 2do grado en Reumatologia

Ana Cristina Noa Rodríguez, Centro Nacional de Toxicología

Investigadora de la Subdirección de Evaluaciones Toxicologicas y Medioambientales del CENATOX

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Published

2023-12-23

How to Cite

1.
Castillo Miranda JC, Toirac Cabrera X, Noa Rodríguez AC. Fever of unknown origin as a form of presentation of an adult-onset Still’s disease. Rev Cubana Med Milit [Internet]. 2023 Dec. 23 [cited 2025 Jun. 7];53(1):e024010128. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/10128

Issue

Vol. 53 No. 1 (2024): January - March

Section

Case Presentation

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