S Diallo, M M Ka, A Pouye, J C Daboiko, A Lèye, F S Ndiaye, N M Kouakou, P Blanche, T M Diop
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引用次数: 0
摘要
成人斯蒂尔氏病是非洲黑人罕见的系统性疾病。我们正在报告一个以诊断困难为特征的病例。观察:这是一名29岁的塞内加尔黑人女性患者,无特殊病史,表现为系统性慢性综合征,包括咽炎、多发性关节炎和一般症状(发烧、发冷、出汗、全身状态改变)、皮肤疹、多腺病、肝脾肿大。生物学分析显示,炎症综合征(1小时内VS为115 mm, CRP为100 mg/L, WBC为10400 /mm3,伴中性粒细胞增多),高铁蛋白血症为643ng /L,糖基化铁蛋白崩溃为13% (N在60 - 80%之间)。在尽可能详尽的检查中消除任何自身免疫或肿瘤化脓性感染病理后,仍保留了成人Still病的诊断。强的松与甲氨蝶呤联合应用后,症状明显改善。结论:虽然它在黑非洲是罕见的,但这种病理应该是任何无法解释的系统体征的鉴别诊断的一部分。铁蛋白血症及其糖基化部分的剂量,以及Yamaguchi和Fautrel的成人Still病分类标准,将允许更早地建立这种潜在严重影响的诊断。
[Still disease in adult: a Senegalese case report].
Introduction: The adult Still's disease is a systematic disease rarely reported in the black Africans. We are reporting a case characterized among other difficulties by its diagnostic difficulties.
Observation: It is about a 29 years old black Senegalese woman patient, without particular antecedents, which presented a systematic chronic syndrome composed of a pharyngitis, a polyarthritis and general symptoms (fever, chills, sweats, change of the general state), a cutaneous eruption, a polyadenopathy, a hepatosplenomegaly. The biological analyses showed among others, an inflammatory syndrome (VS at 115 mm in the 1st hour, CRP at 100 mg/L, WBC at 10,400/mm3 with neutrophilia), a hyperferritinemia in 643 ng/l with collapse of the glycosylated ferritin at 13% (N between 60 in 80%). After elimination of any autoimmune or neoplastic suppurative infectious pathology in the decline of a check up as exhaustive as possible, the diagnosis of a Still disease in adult had been retained. Their was improvement under the combination of prednisone and methotrexate.
Conclusion: Although it is exceptional in black African, this pathology shall be however part of the differential diagnoses of any unexplained systematic sign. The dosage of the ferritinemia and its glycosylated fraction as well as the resort to the criteria of Yamaguchi and Fautrel's classification of Still Disease in Adult shall allow to establish more prematurely the diagnosis of this potentially severe affection.