妊娠晚期并发成人still病1例并文献复习  

Adult-onset Still’s disease complicating late pregnancy:a case report and literature review

作　　者：马友谅 陈凯[1,2] 严健宁 龙禹 MA Youliang;CHEN Kai;YAN Jianning;LONG Yu(Department of Obstetrics,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Obstetrics,People’s Hospital Afffliated to Shandong First Medical University,Jinan 271100,China;Medical Simulator Center,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院产科,南宁530021 [2]山东第一医科大学附属人民医院产科,济南271100 [3]广西医科大学第一附属医院医学模拟中心,南宁530021

出　　处：《广西医科大学学报》2025年第2期309-314,共6页Journal of Guangxi Medical University

基　　金：国家自然科学基金地区项目资助(No.81960282);广西自然科学基金重点项目资助(No.2020GXNSFDA297024);广西卫生健康委员会自筹经费课题资助项目(No.Z-A20220479);广西医科大学第一附属医院优秀医学英才培养计划资助项目(No.201903)。

摘　　要：成人still病(AOSD)是一种罕见的自身炎症性疾病,以非特异性的临床表现和缺乏特异性实验室检查为特征。本文报告1例于分娩后确诊AOSD的34岁女性患者。该患者妊娠晚期出现皮疹、反复高热,并于2024年10月7日经剖宫产分娩壹出生体重为1760 g的早产儿,经多学科团队会诊(MDT)后患者被诊断为AOSD。患者于2024年10月15日从产科办理出院,于当日转入风湿免疫科接受甲泼尼龙40 mg,每天1次治疗。自2024年10月17日起患者未再发热,经治疗后病情好转于2024年10月21日出院。随访至产后42 d,患者炎症指标指标及血清铁蛋白大致恢复至正常,一般情况良好。本文通过病例回顾和文献复习,总结AOSD的临床特征和实验室指标,探讨该疾病的诊断、鉴别诊断和治疗,为临床医生精确诊断、避免误诊提供临床思路。Adult-onset Still’s disease(AOSD)is a rare autoinflammatory disorder characterized by nonspecific clinical manifestations and the absence of definitive laboratory markers.This article presents a case of a 34-yearold female diagnosed with AOSD after delivery.The patient exhibited a rash and recurrent high fever during the late stages of pregnancy,and delivered a premature infant weighing 1,760 g and underwent a cesarean section on October 7,2024.After a consultation by a multidisciplinary team(MDT),the patient was diagnosed with AOSD.The patient was discharged from the obstetrics department on October 15,2024,and transferred to the rheumatology and immunology department for treatment with methylprednisolone 40 mg administered once a day.The patient was discharged from the hospital on October 21,2024,as her condition improved after treatment and she had no recurrence of fever after October 17,2024.At the 42-day postpartum follow-up,the patient’s inflammatory markers and serum ferritin levels were roughly restored to normal,and her general condition was good.Through a review of this case and relevant literature,this article summarizes the clinical features and laboratory indicators of AOSD,discusses its diagnosis,differential diagnosis,and treatment,and provides clinical insights to assist clinicians in achieving accurate diagnosis and avoiding misdiagnosis.

关 键 词：成人STILL病 发热 诊断 鉴别诊断 

分 类 号：R593.2[医药卫生—内科学]