以噬血症候群為初發表現的全身性紅斑狼瘡

Adult-onset Still’s disease presenting with persistent rash

Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. A typical evanescent, erythematous maculopapular rash, which develops at the peak of fever and disappears without residuum, provides an important diagnostic clue. We report a case of a 59-yearold woman who presented with a spiking fever, arthralgia and persistent rash. Serological tests for autoimmune diseases markers, including antinuclear antibody, anti-cardiolipin antibody, and rheumatoid factor were negative. The patient’s white blood cell count was 31771/μL, (segment 92%); ferritin concentration was 21779 ng/mL; erythrocyte sedimentation rate was 130 mm/h; C-reactive protein level was 28.9 mg/dL.