Adult-onset Still's disease with concurrent thrombotic thrombocytopenic purpura: case report and literature review

Ryohei Kato; Tomoyuki Ikeuchi; Katsuyuki Tomita; Akira Yamasaki

doi:10.1136/bcr-2020-235786

Adult-onset Still's disease with concurrent thrombotic thrombocytopenic purpura: case report and literature review

BMJ Case Rep. 2020 Sep 28;13(9):e235786. doi: 10.1136/bcr-2020-235786.

Authors

Ryohei Kato¹, Tomoyuki Ikeuchi², Katsuyuki Tomita², Akira Yamasaki³

Affiliations

¹ Division of Respiratory Medicine and Rheumatology, Department of Multidisclplinary Internal Medicine, Faculty of Medicine, Tottori University Hospital, Yonago, Tottori, Japan.
² Department of Respiratory Medicine, Yonago Medical Centre, National Hospital Organisation Yonago Medical Center, Yonago, Tottori, Japan.
³ Division of Respiratory Medicine and Rheumatology, Department of Multidisclplinary Internal Medicine, Faculty of Medicine, Tottori University Hospital, Yonago, Tottori, Japan yamasaki@tottori-u.ac.jp.

Abstract

Thrombotic thrombocytopenic purpura (TTP) is rare complication resulting from adult-onset Still's disease (AOSD). We report the case of a 69-year-old Japanese man who initially presented with fever and joint pain and was diagnosed as having concurrent AOSD with TTP 1 month later. He had extremely high ferritin levels (32 696 ng/mL). He initially responded to plasma exchange but subsequently died of septic shock. AOSD accompanied by extremely high ferritin levels might be considered a sign of concurrent TTP.

Keywords: rheumatology; thrombotic thrombocytopenic purpura.

Publication types

Case Reports
Review

MeSH terms

Aged
Fatal Outcome
Humans
Male
Plasma Exchange
Purpura, Thrombotic Thrombocytopenic / complications*
Shock, Septic*
Still's Disease, Adult-Onset / complications
Still's Disease, Adult-Onset / diagnosis*