Case Report
Diagnostic Challenge: A Report of Two Adult-Onset Still’s Disease Cases
Table 1
Laboratory findings from two patients presenting with adult-onset Still’s disease.
| | Laboratory data | Patient 1 | Patient 2 |
| | Hemoglobin (12–18 g/dL) | 11.7 | 11.3 | | MCV/MCH (80–99 fL/27–37 pg) | 79.8/26 | 84.8/27.8 | | WBC count (/mm3) | 29,020 | 25,040 | | Neutrophils (40–74%) | 82.0 | 93.5 | | ESR (0–20 mm/hr) | 86 | 94 | | CRP (<5 mg/L) | N/A | 89 | | Ferritin (30–400 ng/ml) | >100,000 | 13,753 | | AST (0–40 U/L) | 385 | 100 | | ALT (0–41 U/L) | 73 | 39 | | ALP (40–130 U/L) | 179 | 94 | | Albumin (3.5–5.2 g/dl) | 2.9 | 3.9 | | LDH (240–480 U/L) | 6,883 | 872 | | Antinuclear antibodies | Homogeneous pattern titer 1 : 320;
rim-like pattern;
anti-cytoplasmic antibodies | Nucleolar pattern titer 1 : 100;
fine-speckled pattern | | Anti-double stranded DNA | Negative | Negative | | Rheumatoid factor (<4.5 IU/ml = negative; 4.5–≤6.0 U/ml = borderline; >6.0 U/ml = positive) | Negative | 23.36 (positive) | | Anti-CCP | Negative | N/A | | Cultures | No growth (blood, urine) | No growth (blood) |
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White blood cell. Erythrocyte sedimentation rate. C-reactive protein. Aspartate transaminase. Alanine transaminase. Alkaline phosphatase. Lactate dehydrogenase. Anti-cyclic citrullinated peptide antibody.
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