Adult-onset Still's Disease with Acute Kidney Injury Requiring Hemodialysis: A Case Report and Literature Review

Intern Med. 2023 Oct 1;62(19):2901-2906. doi: 10.2169/internalmedicine.1026-22. Epub 2023 Feb 22.

Abstract

Adult-onset Still's disease (AOSD) is characterized by high spiking fever, evanescent rash, and arthritis. However, AOSD rarely presents with severe acute kidney injury (AKI). We herein present the case of a 56-year-old woman with new-onset AOSD who rapidly developed AKI. A physical examination and laboratory data revealed spiking fever, evanescent rash, thrombocytopenia, hyperferritinemia, and azotemia. The patient was diagnosed with AOSD complicated by AKI and macrophage activation syndrome. Treatment with high-dose steroids, hemodialysis, and plasma exchange successfully resolved her AKI. In this report, we review previously published reports on AOSD accompanied by AKI and discuss this rare complication in AOSD.

Keywords: Adult-onset Still's disease; acute kidney injury; hemodialysis.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / etiology
  • Acute Kidney Injury* / therapy
  • Adult
  • Exanthema*
  • Female
  • Fever / complications
  • Humans
  • Macrophage Activation Syndrome* / complications
  • Middle Aged
  • Still's Disease, Adult-Onset* / complications
  • Still's Disease, Adult-Onset* / diagnosis
  • Still's Disease, Adult-Onset* / therapy