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Yeungnam Univ J Med > Volume 27(1); 2010 > Article
Yeungnam University Journal of Medicine 2010;27(1):78-84.
DOI:    Published online June 30, 2010.
A Case of Systemic Lupus Erythematosus Misdiagnosed as Adult-onset Still's Disease.
Myung Jin Oh, Hyun Je Kim, Han Sol Lee, Ji An Hur, Young Hoon Hong, Choong Ki Lee
Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
Adult-onset Still's disease (AOSD) is an inflammatory disorder that's characterized by daily, spiking high fever, arthritis and an evanescent, salmon-pink rash. AOSD is diagnosed purely on the basis of the typical clinical features of the illness. The symptoms commonly include swelling of the lymph nodes, enlargement of the spleen and liver, and a sore throat. AOSD is difficult to differentiate from systemic lupus erythematosus (SLE) due to the similar clinical manifestations. We report here on a case of a 16-year-old female patient with autism and epilepsy and who complained of daily spiking fever for 20 days. The patient had maculopapular skin rashes on the face and whole body and lymphadenopathy. The liver function tests were elevated mildly. The initial rheumatoid factor (RF) and antinuclear antibody (ANA) tests were negative. We diagnosed her as having adult-onset Still's disease according to the criteria of Yamaguchi. We successfully treated her with oral prednisolone. But her antinuclear antibody test was changed to positive after discharge. So we finally diagnosed her as having SLE.
Key Words: Adult-onset Still's disease, systemic lupus erythematosus, Antinuclear antibody


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