N Akritidis — Page 2 | PubMed Health

PubMedDate not supplied

Long-term follow-up of patients with adult-onset Still's disease.

OBJECTIVE: To evaluate the long-term outcome of patients with adult-onset Still's disease (AOSD). METHODS: Eleven patients with AOSD who were regularly followed-up during the past 13 years, even after discontinuation of treatment, were evaluated for the long-term prognosis of the disease and its possible complications. RESULTS: No exacerbation of the symptoms was noted during therapy. Only two of the 11 patients exhibited relapse of the systemic disease after discontinuation of treatment. Both patients had previously been on corticosteroids and responded well to reinitiation of therapy. Progressive deforming arthritis was not noted in any patient. Hepatic failure, central nervous system involvement, renal involvement or systematic amyloidosis did not complicate the course of any of the patients. CONCLUSIONS: Long-term prognosis of AOSD may be benign in a significant subset of patients. Further studies should clarify characteristics of the subset of patients for whom disease-modifying therapy is warranted.

Adult↗

PubMedDate not supplied

Gallbladder adenomyomatosis presenting as fever of unknown origin: a case report.

Gallbladder adenomyomatosis is a rare disorder, characterized by benign hyperplasia of the gallbladder mucosa creating invaginations through the muscular layer, known as Rokitansky-Aschoff sinuses. It is considered an acquired disease, with pathophysiology similar to that of the diverticular disease of the colon. Diagnosis is often achieved by ultrasound, but a significant percentage is misdiagnosed as chronic cholecystitis, whereas the diagnosis is finally achieved histologically. We describe a case of gallbladder adenomyomatosis presenting as fever of unknown origin. The patient was a 17-year-old girl with a history of sustained fever of 38.5 degrees C of two months' duration. There were no accompanying symptoms and the whole diagnostic workup, including abdominal ultrasound, was negative. Gallbladder inflammation was evident during an eventual investigatory laparoscopy, and cholecystectomy was performed. The histologic results were consistent with diffuse adenomyomatosis. The patient became afebrile immediately after cholecystectomy. To our knowledge, fever has never been associated with gallbladder adenomyomatosis before in bibliography, nor has adenomyomatosis been mentioned as a cause of fever of unknown origin. We therefore believe that gallbladder adenomyomatosis should be considered in the differential diagnosis of sustained fever with negative workup.

Adenomyoma↗