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KMID : 0388220130200060364
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Journal of the Korean Rheumatism Association
2013 Volume.20 No. 6 p.364 ~ p.368
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A Case Report of Renal Involvement in Adult-Onset Still’s Disease over Age 70
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Yoon Gwang-Seok
Park Won
Baek Ji-Hyeon
Han Jee-Young
Jung Kyong-Hee
Lim Mie-Jin
Joo Ko-woon
Kwon Seong-Ryul
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Abstract
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Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disease characterized by spiking fever, arthralgia, salmon pink rash, neutrophilic leukocytosis, and multi-organ involvement. Although renal involvement may appear in some cases of adult Still’s disease, onset over 70 years of age with renal involvement has not been described. We report a 73-years-old woman whose illness manifested with fever of unknown origin, massive proteinuria, and multiple lymph nodes enlargement. With proteinuria of 2,650 mg/day, a renal biopsy was performed, and histopathological evaluation yielded the diagnosis of chronic glomerulonephritis (CGN). After excluding infectious disease, malignancy, and other rheumatic disease, AOSD was diagnosed with symptoms including fever over 39.0oC for more than a week, leukocytosis, generalized lymphadenopathy, and negative autoantibodies. Proteinuria and fever were improved markedly by high dose glucocorticoids and methotrexate therapy.
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KEYWORD
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Adult-onset Still’s disease , Renal involvement , Proteinuria
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