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MODERN RHEUMATOLOGY Vol.14 No.5
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| A case of paraneoplastic syndrome mimicking adult-onset Still's disease |
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Yukiko Komano1, Tetsuo Kubota1, Shihoko Wakabayashi1, Sae Ochi1, Yoshinori Nonomura1, Hiroyuki Hagiyama1, Toshihiro Nanki1, Hitoshi Kohsaka1 and Nobuyuki Miyasaka1 |
(1) Department of Medicine and Rheumatology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan |
Received: 30 January 2004 Accepted: 28 June 2004 |
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Abstract |
| A 49-year-old woman was admitted to our hospital because of fever of unknown origin. The patient had long-lasting spiking fever, hepatosplenomegaly, pleural effusion, and skin rash. Laboratory tests showed marked leukocytosis and an extremely high serum ferritin level (240 000 ng/ml) accompanied by disseminated intravascular coagulation and hemophagocytic syndrome. Most of the patient's features were compatible with a diagnosis of adult-onset Still's disease (AOSD), the rash, however, was not a typical rheumatoid rash but multiforme erythema. Biopsy of a breast nodule revealed breast cancer, leading us to a diagnosis of paraneoplastic syndrome mimicking AOSD. Although this is a rare disorder, cases resembling the present one have been reported, indicating the importance of including paraneoplastic syndrome in the differential diagnosis of AOSD. |
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| Key words |
| Adult-onset Still's disease (AOSD) - Breast carcinoma - Fever of unknown origin - Hyperferritinemia - Paraneoplastic syndrome |
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