Serial Ga-67 Scintigraphic Findings of Adult Onset Stillʼs Disease

Abstract

Adult-onset Still's disease (AOSD) is a cause of fever unknown origin. The clinical manifestations of AOSD include a high spiking fever, evanescent maculopapular rash, polyarthralgias associated with leukocytosis, and abnormal liver tests. We present serial Ga-67 scintigraphic findings in a young male with persistent remittent fever and the final diagnosis of AOSD. Repeated Ga-67 scintigraphic studies demonstrated diffusely increased activity in the bone marrow, hepatosplenomegaly, and pericarditis in proportion to the severity of the disease. Awareness of the Ga-67 scintigraphic imaging findings of AOSD could help narrow the differential diagnosis among the long list in fever of unknown origin.

Adult-Onset Still’s Disease: Still a Serious Health Problem (a Case Report and Literature Review)

“…Our patient had splenomegaly, elevated liver enzymes (AL and AST), and fever as positive signs for RHS but no pancytopenia and neurological symptoms. Other less common manifestations of AOSD include hepatomegaly [ 11 , 32 , 33 ], pneumonia and pleuritis [ 34 ], thrombotic thrombocytopenic purpura (TTP) [ 35 ], and cardiac involvement (pericarditis and tamponade) [ 36 ].…”