Yeungnam Univ J Med.  2010 Jun;27(1):78-84. 10.12701/yujm.2010.27.1.78.

A Case of Systemic Lupus Erythematosus Misdiagnosed as Adult-onset Still's Disease

• Oh MJ
• Kim HJ
• Lee HS
• Hur JA
• Hong YH
• Lee CK

• KMID: 1462717
• DOI: http://doi.org/10.12701/yujm.2010.27.1.78

Abstract

Adult-onset Still's disease (AOSD) is an inflammatory disorder that's characterized by daily, spiking high fever, arthritis and an evanescent, salmon-pink rash. AOSD is diagnosed purely on the basis of the typical clinical features of the illness. The symptoms commonly include swelling of the lymph nodes, enlargement of the spleen and liver, and a sore throat. AOSD is difficult to differentiate from systemic lupus erythematosus (SLE) due to the similar clinical manifestations. We report here on a case of a 16-year-old female patient with autism and epilepsy and who complained of daily spiking fever for 20 days. The patient had maculopapular skin rashes on the face and whole body and lymphadenopathy. The liver function tests were elevated mildly. The initial rheumatoid factor (RF) and antinuclear antibody (ANA) tests were negative. We diagnosed her as having adult-onset Still's disease according to the criteria of Yamaguchi. We successfully treated her with oral prednisolone. But her antinuclear antibody test was changed to positive after discharge. So we finally diagnosed her as having SLE.

Keyword

Adult-onset Still's disease; systemic lupus erythematosus; Antinuclear antibody

MeSH Terms

Adolescent
Antibodies, Antinuclear
Arthritis
Autistic Disorder
Epilepsy
Exanthema
Female
Fever
Humans
Liver
Liver Function Tests
Lupus Erythematosus, Systemic
Lymph Nodes
Lymphatic Diseases
Pharyngitis
Prednisolone
Rheumatoid Factor
Spleen
Still's Disease, Adult-Onset
Antibodies, Antinuclear
Prednisolone
Rheumatoid Factor