We reported a 49-year-old woman with adult Still's disease. She had developed intermittent fever with chills, polyarthralgia and myalgia since Dec., 1978. Her symptoms could not be controlled by several antibiotic therapy under the suspicion of infectious disease, and investigations in other hospitals during two years failed to make a diagnosis of this case. Then, she refered to our hospital and admitted in Apr. 28, 1980. Polyarthritis on a few joints, and hepatosplenomegaly were demonstrated, and abnormal laboratory data were as follows; Marked leukocytosis (22, 900/cmm; neutrophils 91%), elevation of erythrocyte sedimentation rate (119mm/h), and hypochromic anemia (Hb 9.1g/dl). RA factor was detected in her serum by two methods (RA test 2+, RAHA x 1280). Her synovial fluid obtained from knee joint showed increase of leukocytes (49, 700/cmm; neutrophils 98%), low levels of glucose (10mg/dl) and complement (CH₅₀ 8.4u/ml). Infectious and other rheumatic diseases were ruled-out by detailed examinations including bacteriological and serological studies. Her symptoms except polyarthritis and splenomegaly, were well controlled by the treatment with indomethacin (100mg/day) and prednisolone (10mg/day).
The clinical features of adult Still's disease reported in the literatures were reviewed, and compared with those of this case.