Adult-Onset Still's Disease Complicated by Immunoglobulin A Vasculitis and anti-CCP Antibody-Positive Arthritis

Tohoku J Exp Med. 2021;255(4):297-301. doi: 10.1620/tjem.255.297.ABSTRACTA 38-year-old male was admitted to our hospital for arthralgia, fever, skin rash, and purpura. He was diagnosed as having adult-onset Still's disease (AOSD) based on Yamaguchi's criteria. Skin biopsy revealed immunoglobulin A (IgA) vasculitis. He was also found to have anti-cyclic citrullinated peptide (CCP) antibody-positive inflammatory arthritis on a shoulder joint, however he did not fulfill classification criteria for rheumatoid arthritis. Elevated serum cytokine such as serum IL-18 supported the diagnosis of AOSD. His symptoms improved with 40 mg of prednisolone plus cyclosporin A (200 mg/day). Two years after hospitalization, AOSD was relapsed with pleurisy and hyperferritinemia. Finally, he was diagnosed with multicyclic systemic type of AOSD complicated by IgA vasculitis and seropositivity of anti-CCP antibody. Clinicians need to consider the complication of multiple rheumatic diseases, even if the disease-specific autoantibody is positive.PMID:34897161 | DOI:10.1620/tjem.255.297
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Source Type: research