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Case Reports in Medicine
Volume 2009 (2009), Article ID 504897, 4 pages
http://dx.doi.org/10.1155/2009/504897
Case Report

Myositis, Vasculitis, Hepatic Dysfunction in Adult-Onset Still's Disease

1Division of General Medicine, Department of Internal Medicine, The Jikei University School of Medicine, 163-1, Kashiwashita, Kashiwa, Chiba 277-8567, Japan
2Department of Laboratory Medicine, The Jikei University School of Medicine, 163-1, Kashiwashita, Kashiwa, Chiba 277-8567, Japan

Received 13 March 2009; Accepted 26 May 2009

Academic Editor: Alisa E. Koch

Copyright © 2009 Hidekatsu Yanai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although hepatic dysfunction is common in adult-onset Still's disease (AOSD), sometimes it is difficult to differentiate hepatic dysfunction due to AOSD itself from drug-induced hepatic dysfunction. Further, myalgia often occurs in patients with AOSD; however, AOSD patients complicated with myositis are rare. We report a 43-year-old Japanese man with AOSD who developed myositis and hepatic dysfunction which were deteriorated by multiple nonsteroidal antiinflammatory drugs (NSAIDs) and were dramatically ameliorated by a low-dose steroid therapy. A skin biopsy of salmon pink rash which is characteristic for AOSD showed leukocytoclastic vasculitis, and the markers for vasculitis, plasma von Willebrand factor, and vascular endothelial growth factor levels were elevated in this patient, suggesting an association between AOSD and systemic vasculitis.