A Case Report of Renal Involvement in Adult-Onset Still's Disease over Age 70.
10.4078/jrd.2013.20.6.364
- Author:
Gwang Seok YOON
1
;
Won PARK
;
Ji Hyeon BAEK
;
Jee Young HAN
;
Kyong Hee JUNG
;
Mei Jin LIM
;
Kowoon JOO
;
Seong Ryul KWON
Author Information
1. Department of Internal Medicine, College of Medicine, Inha University, Inha University Hospital, Incheon, Korea.
- Publication Type:Case Report
- Keywords:
Adult-onset Still's disease;
Renal involvement;
Proteinuria
- MeSH:
Adult;
Arthralgia;
Autoantibodies;
Biopsy;
Communicable Diseases;
Diagnosis;
Exanthema;
Female;
Fever;
Fever of Unknown Origin;
Glomerulonephritis;
Glucocorticoids;
Humans;
Leukocytosis;
Lymph Nodes;
Lymphatic Diseases;
Methotrexate;
Neutrophils;
Proteinuria;
Rheumatic Diseases;
Salmon;
Still's Disease, Adult-Onset*
- From:Journal of Rheumatic Diseases
2013;20(6):364-368
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease characterized by spiking fever, arthralgia, salmon pink rash, neutrophilic leukocytosis, and multi-organ involvement. Although renal involvement may appear in some cases of adult Still's disease, onset over 70 years of age with renal involvement has not been described. We report a 73-years-old woman whose illness manifested with fever of unknown origin, massive proteinuria, and multiple lymph nodes enlargement. With proteinuria of 2,650 mg/day, a renal biopsy was performed, and histopathological evaluation yielded the diagnosis of chronic glomerulonephritis (CGN). After excluding infectious disease, malignancy, and other rheumatic disease, AOSD was diagnosed with symptoms including fever over 39.0degrees C for more than a week, leukocytosis, generalized lymphadenopathy, and negative autoantibodies. Proteinuria and fever were improved markedly by high dose glucocorticoids and methotrexate therapy.
