Case Report
Volume: 5 | Issue: 3 | Published: Mar 24, 2021 | Pages: 71 - 75 | DOI: 10.24911/ejmcr/173-1595858983
A case report of Adult Onset Still's Disease and Kikuchi Fujimoto lymphadenitischallenges and learning points
Authors: David Mathew , Urmi Gupta , Uchechi Igbokwe , Sophie Todd , Paul Greaves , Teresa Doherty
Article Info
Authors
David Mathew
Barking, Havering and Redbridge University Trust, Rom Valley Way, Romford, United Kingdom
Urmi Gupta
Barking, Havering and Redbridge University Trust, Rom Valley Way, Romford, United Kingdom
Uchechi Igbokwe
Barking, Havering and Redbridge University Trust, Rom Valley Way, Romford, United Kingdom
Sophie Todd
Barking, Havering and Redbridge University Trust, Rom Valley Way, Romford, United Kingdom
Paul Greaves
Barking, Havering and Redbridge University Trust, Rom Valley Way, Romford, United Kingdom
Teresa Doherty
Barking, Havering and Redbridge University Trust, Rom Valley Way, Romford, United Kingdom
Publication History
Received: July 27, 2020
Revised: December 14, 2020
Accepted: January 02, 2021
Published: March 24, 2021
Abstract
Background: Adult Onset Stills Disease (AOSD) and Kikuchi Fujimoto Lymphadenitis (KFL) are both rare Rheumatological diseases. Co-occurrence is very rare. Case Presentation: This is a case of AOSD and KFL co-occurrence presenting with polyarthritis, rash, and B Symptoms. Elevated serum lactate dehydrogenase and ferritin with anemia and lymphadenopathy raised suspicions of lymphoma. Histology confirmed KFL and clinical features, and raised ferritin confirmed AOSD. After starting sulfasalazine, the patient was admitted to the hospital with Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. Prior to sepsis exclusion, Gentamicin was given and subsequent hearing loss was noted. Sustained remission was achieved with Tocilizumab and azathioprine. Tocilizumab was stopped during pregnancy. Conclusion: The diagnostic challenges of two rare overlapping Rheumatological diseases are highlighted. An early distinction of disease flares or drug reactions from sepsis is difficult. Risk-benefit ratio consideration of continuing successful treatments in pregnancy is acknowledged.
Keywords: Case report, adult onset still disease, Kikuchi Fujimoto lymphadenitis, green
