Stillova bolest odraslih kod bolesnika starije životne dobi – prikaz bolesnika

Indira Melezović, Samir Mehmedagić, Lejla Granulo, Mevludin Mekić, Emela Čvorak

Introduction: Adult-onset Still’s disease (AO SD) is a rare systemic inflammatory disorder characterized by a triad of symptoms: fever, transient maculopapular rash, arthralgia or arthritis. Symptoms of the disease usually appear before the age of sixteen, and if they do, then that is the case of systemic juvenile idiopathic arthritis. The appearance of clinical symptoms in adulthood usually occurs by the age of 46. Rare cases of disease occurrence in patients over sixty years of age are described in the literature.

Case report: We present the case of a 73-year-old patient with numerous comorbidities who was admitted to our inpatient ward due to a protracted febrile condition accompanied by rash and arthralgia. After excluding infection and malignancy, we have finally diagnosed the patient with AO SD.

Conclusion: Despite the fact that AO SD is typically diagnosed in young adulthood, the diagnosis of this condition is possible even in the elderly, after exclusion of other more common differential diagnoses.

Uvod: Stillova bolest odrasle dobi (engl. AO SD – adult onset Still’s disease) rijedak je sistemski upalni poremećaj karakteriziran trijasom simptoma: povišenom tjelesnom temperaturom, prolaznim makulopapuloznim osipom te artralgijama ili artritisom. Obično se simptomi bolesti javljaju prije šesnaeste godine života i tada govorimo o sistemskom juvenilnom idiopatskom artritisu. Pojava kliničkih simptoma u odrasloj dobi obično se javlja do 46. godine života. U literaturi su opisani rijetki slučajevi pojave bolesti kod bolesnika starijih od šezdeset godina. Prikaz slučaja: U ovom radu predstavljamo slučaj 73-godišnjeg bolesnika s brojnim komorbiditetima koji je hospitaliziran zbog protrahiranoga febrilnog stanja praćenog osipom i artralgijama. Isključenjem infekcije i maligne bolesti u konačnici smo postavili dijagnozu Stillove bolesti starije životne dobi. Zaključak: Iako se Stillova bolest odrasle dobi najčeće razvija u mlađih odraslih, dijagnoza ovog stanja dolazi u obzir i u bolesnika starije životne dobi nakon isključenja mogućih diferencijalnih dijagnoza.