Bilateral scleritis at the onset of macrophage activation syndrome

A 16-year-old girl with a history of Still disease, diagnosed at the age of 6 and in remission since 2020, presented to the emergency department with persistent high fever (38.7 °C), skin rash, cervical and angulo-mandibular lymphadenopathies, splenomegaly (A), neutrophilic leukocytosis, thrombocytopenia, elevation of liver enzymes and hypofibrinogenemia. She also complained of abdominal pain, diffuse myalgia, headache and ocular pain associated with redness in both eyes. Acute phase reactants were markedly elevated (ESR: 86 mm/h; CRP: 40.31 mg/dl; ferritin 5074 ng/ml).
Source: American Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Illustrations & Insights Source Type: research