A 27-year-old woman presented with a 2-week history of joint pain, fever, sore throat, and a nonpruritic rash that worsened during febrile episodes. Physical examination was notable for generalized lymphadenopathy and swelling of the wrists, knees, and ankles. Laboratory studies showed neutrophilic leukocytosis, an elevated C-reactive protein level and erythrocyte sedimentation rate, and ferritin level of 4053 μg per liter (reference range, 10 to 200). An antinuclear antibody was negative. Which of the following is the most likely diagnosis?
一名27岁女性因关节疼痛、发热、咽痛及非瘙痒性皮疹就诊2周，且皮疹在发热期间加重。体格检查发现全身淋巴结肿大及腕、膝、踝关节肿胀。实验室检查显示中性粒细胞性白细胞增多、C反应蛋白及红细胞沉降率升高，铁蛋白水平为4053 μg/L（参考范围：10至200）。抗核抗体阴性。最可能的诊断是什么？
A. Adult-onset Still’s disease成人斯蒂尔病
B. Drug reaction with eosinophilia and systemic symptoms伴嗜酸性粒细胞增多和系统症状的药疹
C. Parvovirus B-19B19细小病毒
D. Sarcoidosis结节病
E. Scarlet fever猩红热
答案解析：
所有自身免疫及感染性疾病的相关检测均为阴性，最终确诊为成人斯蒂尔病。斯蒂尔病是一种罕见的自身炎症性疾病，其特征为发热、多发性关节炎及一过性皮疹（患者退热后皮疹可消退）。该病的诊断需建立在排除感染、恶性肿瘤及自身免疫性疾病的基础上，且患者表现出典型的临床表现并伴有炎症标志物及铁蛋白水平的升高。
正确答案：A
原创文章（本站视频密码：66668888），作者：xujunzju，如若转载，请注明出处：https://zyicu.cn/?p=21996
微信扫一扫 
支付宝扫一扫 
