A Rare Case of Adult-onset Still’s Disease with Anti-Ro Antibody Positive

Sodavarapu, Soujanya; Asad, Marium; Rudrangi, Rajani

doi:10.7759/cureus.6055

Cited by 2 publications

(2 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…retrospectively analyzed 61 Chinese patients with AOSD and reported that ANA was positive in seven of the 61 patients (11.5%) ( 6 ). Other immunological abnormalities described in patients with AOSD include rheumatoid factor, anti-cyclic citrullinated peptide antibody, anti-SS-A/Ro antibodies, anti-dsDNA antibodies, and anti-neutrophil cytoplasmic antibodies ( 4 , 7 – 10 ). Although rare, there have been reports of an overlap of AOSD with other rheumatic diseases, such as Sjogren’s syndrome and systemic scleroderma ( 11 – 16 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: A Rare Case of Elderly-Onset Adult-Onset Still’s Disease in a Patient With Systemic Lupus Erythematosus

et al. 2022

View full text Add to dashboard Cite

The rare systemic inflammatory disorder ‘adult-onset Still’s disease (AOSD)’ is characterized by recurrent fever, evanescent rash, arthralgia, and leukocytosis with neutrophilia. The Yamaguchi criteria are widely used to diagnose AOSD; these criteria can be used for diagnosis after a wide range of infectious, rheumatic, and neoplastic diseases have been excluded. AOSD generally does not overlap with other rheumatic diseases. We present the rare case of an 80-year-old Japanese woman who presented with arthralgia, fever, and skin rash during treatment for systemic lupus erythematosus (SLE), which was finally diagnosed as an overlap of AOSD. Blood tests revealed leukocytosis with neutrophilia, high C-reactive protein (CRP), and liver dysfunction. Her anti-ds-DNA antibody titer and serum complement titer were at the same level as before and remained stable. We suspected AOSD based on the high serum ferritin level but hesitated to diagnose AOSD because of the patient’s SLE history. We measured serum interleukin (IL)-18; it was extremely high at 161,221 pg/mL, which was strongly suggestive of AOSD. We thus diagnosed AOSD complicated during the course of treatment for SLE. The patient’s arthralgia and high CRP level persisted after we increased her oral prednisolone dose and added oral methotrexate, but her symptoms eventually improved with the addition of intravenous tocilizumab. We note that the presence of autoantibodies or other rheumatic diseases cannot be absolutely ruled out in the diagnosis of AOSD. Although high serum IL-18 levels are not specific for AOSD, the measurement of serum IL-18 may aid in the diagnosis of AOSD in similar rare cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Case Report: A Rare Case of Elderly-Onset Adult-Onset Still’s Disease in a Patient With Systemic Lupus Erythematosus

et al. 2022

View full text Add to dashboard Cite

show abstract

“…After doing a retrospective analysis of 61 Chinese patients with AOSD, Zeng et al found that seven of the 61 patients (11.5%) had positive ANA results [14]. Rheumatoid factor, anti-cyclic citrullinated peptide antibody, anti-SS-A/Ro antibody, anti-dsDNA antibody, and anti-neutrophil cytoplasmic antibodies are among the other immunological abnormalities that have been reported in individuals with AOSD [6,15,16]. There have been instances of AOSD's overlap with other rheumatic disorders, including systemic sclerosis and Sjogren's syndrome [17][18][19].…”

Section: Minor Criteriamentioning

confidence: 99%

Chronic Adult-Onset Still’s Disease With Positive Antinuclear Antibodies: Navigating Diagnostic Dilemmas and Clinical Implications

Nagpure,

Raju,

Dube

et al. 2024

Cureus

View full text Add to dashboard Cite

Adult-onset Still's disease (AOSD) is a rare systemic autoinflammatory disorder characterized by fever, rash, and joint pain. Despite primarily affecting young adults, it can occur at any age, presenting diagnostic challenges due to its heterogeneous nature and lack of specific laboratory findings. The subset of AOSD with positive antinuclear antibody (ANA) adds complexity, potentially overlapping with other autoimmune conditions. We describe a case of a 30-year-old female with a two-year history of fever, weight loss, and joint pain, initially misdiagnosed as seronegative arthritis with hypothyroidism. Further evaluation revealed severe anemia, leucocytosis, and hepatosplenomegaly. Despite a strongly positive ANA, the absence of systemic lupus erythematosus (SLE) features led to a diagnosis of chronic AOSD. Treatment with steroids and disease-modifying antirheumatic drugs (DMARDs) resulted in clinical improvement, highlighting the importance of accurate disease classification for tailored management in ANA-positive AOSD. This case underscores the diagnostic challenges of AOSD and emphasizes the need for precise classification for optimal treatment strategies.

show abstract

A Rare Case of Adult-onset Still’s Disease with Anti-Ro Antibody Positive

Cited by 2 publications

References 6 publications

Case Report: A Rare Case of Elderly-Onset Adult-Onset Still’s Disease in a Patient With Systemic Lupus Erythematosus

Case Report: A Rare Case of Elderly-Onset Adult-Onset Still’s Disease in a Patient With Systemic Lupus Erythematosus

Chronic Adult-Onset Still’s Disease With Positive Antinuclear Antibodies: Navigating Diagnostic Dilemmas and Clinical Implications

Contact Info

Product

Resources

About