[Systemic Inflammatory Response in a Young Woman].

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Adult Still disease is a rare systemic autoinflammatory disorder characterized by fever, rash, and joint pain.
• Diagnosis requires excluding other potential causes of systemic inflammation.

Observation:

• A 21-year-old female presented with recurrent fever, arthralgias, and a characteristic salmon-colored rash.
• Laboratory findings included neutrophilic leukocytosis, elevated C-reactive protein (CRP), ferritin, ASAT, and ALAT.

Findings:

• The patient was diagnosed with adult Still disease after a thorough exclusion of differential diagnoses.
• Initial treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and prednisolone provided insufficient symptom control.
• Escalation of therapy to tocilizumab, an interleukin-6 (IL-6) antagonist, resulted in significant symptom improvement.

Implications:

• This case highlights the diagnostic challenges of adult Still disease.
• It underscores the efficacy of IL-6 inhibition with tocilizumab in managing refractory adult Still disease.
• Early recognition and targeted immunosuppressive therapy are crucial for favorable outcomes in patients with this rare condition.