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

Adult-onset Still’s disease (AOSD) is a rare clinical entity with unknown etiology, characterized by evanescent rash, arthritis, fever, and other systemic presentation. In this case report, we describe a male patient of 50 years, previously diagnosed as a case of Adult onset still’s disease based on Yamaguchi criteria after the exclusion of other potential diagnoses. Later he was admitted into the Medicine department of Chittagong Medical College Hospital where he was found to have serological features of Systemic lupus erythematosus, another very much uncommon autoimmune disorder in male. On several occasion of his past admissions, SLE and RA were excluded meticulously. He initially responded to oral steroids only, recurrence of symptoms led us to work on the underlying etiology further. Coexistence of SLE in a patient with AOSD is not so commonly found. In our case, we notice this interesting phenomenon which was crucial for his management. Bangladesh J Medicine July 2019; 30(2) : 100-103

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Serum β2-microglobulin level is a useful indicator of disease activity and hemophagocytic syndrome complication in systemic lupus erythematosus and adult-onset Still’s disease

Clinical Rheumatology ◽

10.1007/s10067-013-2220-8 ◽

2013 ◽

Vol 32 (7) ◽

pp. 999-1005 ◽

Cited By ~ 16

Author(s):

Kuninobu Wakabayashi ◽

Shigeko Inokuma ◽

Erika Matsubara ◽

Kae Onishi ◽

Hiromitsu Asashima ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Disease Activity ◽

Lupus Erythematosus ◽

Hemophagocytic Syndrome ◽

Adult Onset Still’S Disease ◽

Adult Onset ◽

Still’S Disease ◽

Systemic Lupus ◽

Β2 Microglobulin ◽

Adult Onset Still's Disease

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Adult-Onset Still’s Disease Associated with Thyroid Dysfunction: Case Report and Review of the Literature

The Open Rheumatology Journal ◽

10.2174/1874312901408010009 ◽

2014 ◽

Vol 8 (1) ◽

pp. 9-12 ◽

Cited By ~ 1

Author(s):

Yingchun Hu ◽

Han Wang ◽

Juelin Deng

Keyword(s):

Autoimmune Disease ◽

Lupus Erythematosus ◽

Adult Onset Still’S Disease ◽

Systemic Autoimmune Disease ◽

Adult Onset ◽

Still’S Disease ◽

Autoimmune Thyroid ◽

The Past ◽

Still's Disease ◽

Adult Onset Still's Disease

To our knowledge, the possible unveiled interaction between adult-onset Still’s disease (AOSD) with autoimmune thyroid disease (AITD) has never been reported although it is well established that systemic autoimmune disease may usually occur in relation to AITD. As increasingly clear links of AITD with other autoimmune disease such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and primary Sjögren’s syndrome (pSS) have been reported, and the incidence of AOSD concurrent AITD draws our attention rapidly. In this study, we searched relevant literatures published in the past 30 years to explore that condition.

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Allelic frequency of the MCP-1 promoter −2518 polymorphism in the Korean population and in Korean patients with rheumatoid arthritis, systemic lupus erythematosus and adult-onset Still's disease

European Journal of Immunogenetics ◽

10.1046/j.1365-2370.2002.00346.x ◽

2002 ◽

Vol 29 (5) ◽

pp. 413-416 ◽

Cited By ~ 37

Author(s):

S.-Y. Hwang ◽

M.-L. Cho ◽

B. Park ◽

J.-Y. Kim ◽

Y.-H. Kim ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Allelic Frequency ◽

Korean Population ◽

Adult Onset Still’S Disease ◽

Still’S Disease ◽

Systemic Lupus ◽

Korean Patients ◽

Adult Onset Still's Disease

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Adult-onset Still's disease presenting lupus erythematosus-like facial erythema associated with Kikuchi's disease

European Journal of Dermatology ◽

10.1684/ejd.2012.1855 ◽

2012 ◽

Vol 22 (6) ◽

pp. 798-799 ◽

Cited By ~ 1

Author(s):

Takako Miura ◽

Toshiyuki Yamamoto

Keyword(s):

Lupus Erythematosus ◽

Adult Onset Still’S Disease ◽

Adult Onset ◽

Still’S Disease ◽

Kikuchi’S Disease ◽

Still's Disease ◽

Facial Erythema ◽

Kikuchi's Disease ◽

Adult Onset Still's Disease

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IL-18 Serum Level in Adult Onset Still’s Disease: A Marker of Disease Activity

International Journal of Inflammation ◽

10.1155/2012/156890 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 33

Author(s):

Serena Colafrancesco ◽

Roberta Priori ◽

Cristiano Alessandri ◽

Carlo Perricone ◽

Monica Pendolino ◽

...

Keyword(s):

Disease Activity ◽

Lupus Erythematosus ◽

Therapeutic Option ◽

Serum Levels ◽

Adult Onset Still’S Disease ◽

Adult Onset ◽

Still’S Disease ◽

Still's Disease ◽

Human Sera ◽

Adult Onset Still's Disease

Introduction. Immunological factors seem to play a pivotal role in Adult Onset Still's Disease (AOSD). Among all, IL-18 cytokine is overexpressed and drives the inflammatory process.Objective. We aimed to investigate the levels of IL-18 in sera of Italian patients with AOSD and to assess its possible role as a marker of disease activity.Methods. IL-18 serum levels were determined by ELISA in 26 Italian patients with AOSD. Disease activity was assessed using Pouchot’s criteria. As controls, 21 patients with Rheumatoid Arthritis (RA), 21 patients with Sjogren's Syndrome (SS), 20 patients with Systemic Lupus Erythematosus (SLE), and 21 healthy subjects (normal human sera, NHS) were evaluated.Results. IL-18 serum levels were significantly higher in patients with active AOSD than in non-active (P=0.001) and control groups (RAP=0.0070, SSP=0.0029, SLEP=0.0032, NHSP=0.0004). A significant correlation between IL-18 serum levels and disease activity (P<0.0001), and laboratory parameters as ferritin (P=0.0127) and C-reactive protein (P=0.0032) was demonstrated.Conclusions. Higher levels of IL-18 are detected in active AODS patients and correlate with disease activity and inflammatory laboratory features. ROC-AUC analysis of the serum concentration of IL-18 suggests that it can be considered a diagnostic marker of AOSD. This paper supports the targeting of this cytokine as a possible therapeutic option in AOSD.

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