糖尿病合并Still病老年患者1例诊治

Diagnosis and treatment for one case of elderly diabetes complicated with Still's disease

成人Still病(adult onset Still's disease,AOSD)是一种以长时间间歇高热、一过性皮疹、关节炎或关节痛为主要表现,伴有粒细胞增高,肝、脾及淋巴结肿大等多系统受累的临床综合征。1例71岁2型糖尿病患者出现高热、皮疹、关节痛及粒细胞增高,在多次复查铁蛋白后确诊为AOSD。临床医师需提高对该病的认识以便作出早期诊断。对于老年糖尿病患者,即使早期铁蛋白不高,但当临床上症状及体征符合,尤其抗感染治疗效果差时,须高度怀疑该病,并及时多次复查铁蛋白以早期明确诊断。

Adult onset Still＇s disease（AOSD） is a clinical syndrome with multiple organ failure.The patients normally show intermittent high fever for a long time,a transient rash,arthritis or joint pain as the main performance,accompanied by an increase in granulocytes and enlargement in liver,spleen and lymph node.A 71-years-old female patient with type 2 diabetes admitted hospital because of high fever,skin rash,joint pain and increased granulocyte.After review of the iron protein,she was diagnosed as AOSD.We found that clinicians need to improve the understanding for this disease in order to make the early diagnosis,especially in elderly patients with diabetes mellitus.In such patients,ferritin may not be high at early time.However,when the symptoms and signs are consistent with clinical manifestations,and anti-infection treatment effect is poor,we should pay attention to the disease,and repeated review of ferritin is necessary to assist the early diagnosis.