Fever of unknown origin and marked hyperferritinemia in a young patient: a diagnostic and therapeutic challenge.
DOI:
https://doi.org/10.62059/0mchs664Keywords:
Adult-onset Still’s disease, Ferritin, Anakinra, Yamaguchi criteria, Autoinflammatory diseasesAbstract
Adult-onset Still's disease (AOSD) is a rare autoinflammatory disorder characterized by fever, rash, and arthralgia, constituting an uncommon cause of fever of unknown origin. Its diagnosis remains primarily one of exclusion. Case report: A 27-year-old woman presented with fever up to 40°C, odynophagia, and a transient salmon-colored rash. Laboratory findings were notable for neutrophilic leukocytosis, marked elevation of acute-phase reactants, and hyperferritinemia of 2800 ng/ml. After ruling out infectious, neoplastic, and autoimmune processes, the diagnosis of AOSSD was established. The patient responded rapidly to glucocorticoids and biologic treatment with anakinra, achieving clinical and laboratory remission. Conclusion: Marked hyperferritinemia and adherence to clinical criteria remain key diagnostic indicators. Early initiation of IL-1 inhibitors is currently a priority therapeutic strategy according to the EULAR/PReS 2024 recommendations.
References
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2. Fautrel B, Mitrovic S, De Matteis A, et al. EULAR/PReS recommendations for the diagnosis and management of Still’s disease, comprising systemic juvenile idiopathic arthritis and adult-onset Still’s disease. Ann Rheum Dis. 2024. doi:10.1136/ard-2024-225851.
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Copyright (c) 2026 Maritza Daniela Diaz Carlotti, Manuel Cifrian Perez (Autor/a)
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