Abstract

REFRACTORY SHOCK WITH MULTIPLE ORGAN DYSFUNCTION: A FATAL CASE REPORT ON ADULT ONSET STILLS DISEASE

Elna Paul*, Niby, Aishwarya T. V., Menaka K., Haja Sherief S. and Sivakumar T.

ABSTRACT

Adult onset Still's disease (AOSD) is a chronic multi-system inflammatory disorder characterized by high spiking fever, polyarthralgia and skin rash. Lymphadenopathy is another prominent feature of adult onset Still's disease. This report describes a 47 years old male presented with fever, multiple joint pains, cough and pus discharge from nails. Examination revealed fever, typical skin rash, generalized lymphadenopathy and polyarthritis. On investigation there were neutrophilic leukocytosis, high ESR, high ferritin level, raised liver enzymes, but RA test and ANA test were negative. All of his history, clinical examinations and laboratory findings fulfill the diagnostic Yamaguchi criteria for AOSD after the exclusion of other potential diagnoses. We report on a case of AOSD presenting with multiple organ failure which leads to death.

Keywords: Fever, skin rash, polyarthritis, Adult onset still’s disease, ANA, ESR.