摘要
成人Still病(adult-onset Still's disease,AOSD)是一种病因尚不完全明确的临床综合征,临床上主要表现有高热、一过性皮疹、关节痛和/或关节炎、咽痛和白细胞计数明显升高,同时常伴有淋巴结、肝及脾肿大等。AOSD发病症状及方式差异较大,临床上反复发热伴皮疹的患者,易被误认为过敏反应,随着病程进展可能进一步出现神经系统表现及血液系统病变,临床症状表现较为复杂,且目前尚缺少特异性的诊断方法,因而误诊率较高。本文介绍了1例反复发热的患者,先后两次于外院诊断为病毒性脑膜炎,治疗效果不佳。在本院诊断为AOSD,给予激素及免疫抑制剂治疗后病情稳定。因此,临床上遇见不明原因反复发热,抗感染效果不佳情况下,需警惕免疫系统相关疾病,特别是AOSD。本文通过分享本病例报告,以期提高临床对AOSD的认识,避免漏诊、误诊,贻误病情。
Adult-onset Still's disease(AOSD)is a clinical syndrome whose etiology is not yet clear,its clinical manifestations include high fever,transient rash,arthralgia and/or arthritis,sore throat and significantly increased white blood cell count,often accompanied by lymphadenopathy,hepatomegaly and splenomegaly.There are significant differences in the symptoms and modes of AOSD,patients with recurrent fever and rash in clinical practice are easily mistaken for allergic reactions,as the disease progresses,further neurological and hematological changes may occur,resulting in complex clinical symptoms,additionally,there is currently a lack of specific diagnostic methods,resulting in a high misdiagnosis rate.This article describes a patient with recurrent fever,who was diagnosed with viral meningitis twice in an external hospital,but the treatment effect was not satisfactory.The patient was diagnosed as AOSD in our hospital,and his condition was stable after treatment with hormone and immunosuppressive drug.Therefore,when encountering unexplained recurrent fever and poor anti infection effects in clinical practice,it is necessary to be vigilant against immune system related diseases,especially AOSD.This article hopes to share this case report to improve clinical understanding of AOSD and avoid misdiagnosis and missed diagnosis,which may delay the condition.
作者
张晓芹
王万红
ZHANG Xiaoqin;WANG Wanhong(Department of Endocrinology,People's Hospital of Rizhao Lanshan,Rizhao,Shandong,276800,China)
出处
《当代医学》
2025年第3期150-152,共3页
Contemporary Medicine
