Adult-onset Still's disease in a Nigerian woman

Abstract

Adult-onset Still's disease (AOSD) is an uncommon systemic inflammatory disorder of unknown aetiology. Although there have been reports and series elsewhere, there have been very few such reports on black Africans. The rarity of the reporting of this disease has been associated with a low index of suspicion and hence delayed diagnosis in patients suffering from it. We report a case of a 28-year-old woman, a teacher, who had been repeatedly treated for malarial fever over a 2-month period. She was also briefly managed elsewhere for systemic lupus erythematosus due to a persistent fever with associated polyarthralgia, sore throat, rash and high erythrocyte sedimentation rate. On presentation to our facility, she fulfilled the Yamaguchi criteria for AOSD and had a markedly elevated serum ferritin level. She was successfully managed with etanercept and methotrexate. This is the first report of AOSD from Nigeria.

Recurring Lower Abdominal Pain and Fever as Initial Presentation of Adult Onset Still’s Disease in the Absence of Arthralgia and Other System Involvement

“…Most patients diagnosed with AOSD recovered well and their function returned to normal. However, a consistent finding in the literature is that approximately one third of ASOD patients develop erosive Rheumatoid pattern polyarthritis [11][12][13][14][15] . This emphasises the importance of considering early AOSD diagnosis in any patient admitted with pyrexia of unknown origin with normal microbiological, autoimmune screen, body imaging, and bone marrow biopsy.…”

Adult-Onset Still’s Disease in an Adult Nigerian Male - A Case Report

“…5 The rarity of the condition has led to a low index of suspicion among clinicians. Four cases of AOSD have been reported so far in Nigeria, [6][7][8] with the first reported in 2015 by Akintayo et al 6 We report the fifth case of AOSD diagnosed at a rural tertiary facility in South-south Nigeria.…”

Paving a Shorter Path Towards Diagnosis: A Case on Adult Onset Still’s Disease from Pakistan

“…Furthermore, as the path towards reaching the AOSD diagnosis is so lengthy, it is natural that several prior diagnoses are made along the way, in as many as 80% of the patients [ 14 ]. Our patient was misdiagnosed as a case of malaria and enteric fever, the latter being the perceived diagnosis for 6.66% of AOSD patients in a previous Pakistani study as well [ 10 ].…”