An unusual manifestation in a patient with adult-onset Still's disease: Minimal glomerular lesion.

Autor: El Mezouar I; Department of Rheumatology, CHU Hassan II University Hospital, Fez, Morocco., Abourazzak FZ; Department of Rheumatology, CHU Hassan II University Hospital, Fez, Morocco., Ghani N; Department of Rheumatology, CHU Hassan II University Hospital, Fez, Morocco., Harzy T; Department of Rheumatology, CHU Hassan II University Hospital, Fez, Morocco.
Jazyk: angličtina
Zdroj: European journal of rheumatology [Eur J Rheumatol] 2014 Sep; Vol. 1 (3), pp. 123-124. Date of Electronic Publication: 2014 Sep 01.
DOI: 10.5152/eurjrheumatol.2014.027
Abstrakt: Adult-onset Still's disease (AOSD) is a multisystem inflammatory disease of unknown etiology. It is characterized by arthritis, hectic fever, transient rash and visceral lesions such as pleuropericarditis, lymphadenopathy and hepato splenomegaly. Although kidney involvement may appear in some cases of AOSD, minimal glomerular lesion (MGL) has not been described. We describe a female patient, who presented with multisystemic manifestations, including high spiking fever, arthralgias, striking hyperferritinemia, and proteinuria. Renal biopsy showed classic MGL. A diagnosis of AOSD was made on the basis of Yamaguchi's criteria. The patient was treated with steroids, resulting in remission of the rheumatological condition closely paralleled by remission of proteinuria, thereby strongly suggesting a causative link between AOSD and MGL in this patient. Renal involvement in the AOSD was rarely reported in the literature. MGL may be a cause of unexplained proteinuria in AOSD. In this situation, renal biopsy is necessary to establish a definitive diagnosis.
Databáze: MEDLINE