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PLÖROPERİKARDİT İLE SEYREDEN ERİŞKİN STİLL HASTALIĞI

ADULT ONSET STILL’S DISEASE WITH PLEUROPERICARDITIS

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2010

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
We present a case of adult onset Still‟s disease (AOSD) revealed by pleuropericarditis. A 33 yr old man was admitted with fever, fatigue, chest and back pain. Radiological and laboratory investigations showed pleuropericarditis with leucocytosis, anemia, high erthyrocyte sedimentation rate and serum C- reactive protein level. Pleural fluid consisted predominantly of lymphocytes. Cytological and microbiological analysis were inconclusive and empiric antituberculous therapy with methylprednisolone was started. The symptoms improved. When steroid doses were reduced, clinical and laboratory findings worsened. Thoracoscopic pleural biopsy was obtained and it showed chronic fibrinous pleuropericarditis. Hepatosplenomegaly and history of arthralgia, high ferritin levels, negative ANA, RF, were consistent with AOSD. Antituberculosis therapy was stopped. Methotrexate was started. Since the diagnosis of AOSD requires the exclusion of specific etiologies of pleuropericarditis, it may be defined with some delay in time.
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Abstract (Original Language): 
Plöroperikardit nedeni araĢtırılırken eriĢkin Still hastalığı (ESH) tanısı almıĢ bir olgu bildirilmiĢtir. Yüksek ateĢ, halsizlik, göğüs ve sırt ağrısıyla baĢvuran otuz üç yaĢında erkek olguda; lökositoz, anemi, yüksek sedimentasyon hızı ve C-reaktif protein düzeyi, plöroperikardit saptandı. Lenfositten zengin plevral sıvının sitolojik ve mikrobiyolojik incelemelerinde spesifik patoloji saptanmayınca ampirik antitüberküloz ve metilprednizolon tedavisi baĢlandı. Metilprednizolon dozu azaltıldığında semptomlarda kötüleĢme olunca torakoskopik biyopsi yapılıp kronik fibrinöz perikardit saptandı. Fizik muayenede hepatosplenomegalinin eĢlik etmesi ve özgeçmiĢinde artralji olması üzerine ESH düĢünüldü. Serum ANA ve RF düzeyi negatif , ferritin düzeyi yüksek saptandı. Tüberküloz tedavisi kesilip kortikosteroid tedavisine metotreksat eklendi. Fizik muayene ve laboratuar bulguları düzeldi. ESH‟de baĢlangıç bulgusu plöroperikardit olduğunda, öncelikle etiyolojiye yönelik spesifik nedenlerin dıĢlanması gerektiğinden, hastalığın tanımlanması gecikebilir.
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  • 1
14-17
  • Turkish

REFERENCES

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