成人Still's Disease－病例報告

Adult Onset Still’s Disease（AOSD）臨床症狀包括間歇性高燒，關節痛，皮膚紅疹，喉嚨痛，淋巴節腫大，肌肉痠痛，厲害者甚至有胸膜炎或心膜炎等，血液檢查呈白血球增多，血中鐵蛋白增高，類風濕性因子及抗核抗體為陰性，肝功能異常等，診斷上須先排除其他疾病，包括感染，腫瘤，自體免疫疾病等，此病好發於年輕女性，其致病機轉未明，但治療預後大都良好。本科於1999年7~8月間經歷一24歲女性，主訴近一個月來常常有間歇性高燒，喉嚨痛，全身肌肉關節痠痛，右側頸部淋巴節輕微腫大，血液檢查白血球增加，胸部X光正常，血液及咽喉擦拭培養均呈陰性，經抗生素治療無效，在排除其他原因後，診斷為AOSD，給予NSAID治療，高燒逐漸消退，症狀獲得緩解，患者持續接受門診追蹤，目前控制情形良好。

關鍵字

成人Still氏症；間歇性高燒；關節痛；皮膚紅疹；喉嚨痛

並列摘要

Adult Onset Still’s Disease (AOSD) is characterized by spiking fever, arthralgia, tran-sient skin rash, sore throat, lymphadenopathy, and organ dysfunction. The laboratory features of AOSD include leukocytosis, hyperferritinemia, negative rheumatoid factor and antinuclear antibody tests, and abnormal liver function. The establishment of the diag-nosis relies on the presence of compatible clinical features and the exclusion of other differential diagnosis such as neoplastic disorders, infection and other autoimmune diseases. It affects mostly young females and the etiology is unclear. The overall progno-sis of AOSD is good. We report a 24-year-old woman, who presented with spiking fever, sore throat, general myoarthralgia and slightly enlarged lymph node of right upper neck for one month. The diagnosis of AOSD was considered after courses of antibiotics with-out effect and exclusion of other differential diagnosis. NSAIDs and steroids were effect-tive for relief of fever and other systemic symptoms in this patient. She remained well under our follow-up at the out-patient department. AOSD is a clinical diagnosis and a diagnosis of exclusion; however, its prompt recognition will avoid delay in initiating ther-apy and unnecessary diagnostic procedures.

並列關鍵字

Adult Onset Still's Disease ； spiking fever ； arthralgia ； skin rash ； sore throat

國際替代計量

成人Still's Disease－病例報告

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