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首页> 外文期刊>Modern rheumatology >A case of adult-onset Still's disease (AOSD)-like manifestations abruptly developing during confirmation of a diagnosis of metastatic papillary thyroid carcinoma
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A case of adult-onset Still's disease (AOSD)-like manifestations abruptly developing during confirmation of a diagnosis of metastatic papillary thyroid carcinoma

机译：确诊转移性甲状腺乳头状癌的过程中突然发展成成人性斯蒂尔氏病（AOSD）样表现的病例

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A 68-year-old Japanese man was admitted to our hospital suffering from abrupt onset of high fever accompanied by arthralgia, myalgia, sore throat, macular eruption, and liver dysfunction. Six months before the onset of these manifestations, 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (18FFDG PET/CT) had detected, unexpectedly, three calcified thyroid lesions without 18F-FDG uptake. Two months before the onset of the present manifestations, ultrasonography- guided fine-needle aspiration had led to a diagnosis of papillary thyroid carcinoma (PTC). Soon after the occurrence of the rheumatic manifestations, a subsequent 18F-FDG PET/CT scan showed not only the three thyroid lesions, the same as those in the previous scan, but also 18FFDG uptake in the thyroid lesion. A diagnosis of adultonset Still's disease (AOSD)-like manifestations associated with PTC was made, and treatment with 40 mg/day of prednisolone (PSL) resolved the symptoms promptly. PSL was gradually tapered, without recurrence of the (AOSD)- like manifestations. Five months after the initiation of treatment with PSL, total thyroidectomy, followed by 131I thyroid ablation treatment, was performed while the patient was on a PSL dose of 18 mg/day. Seven months after the thyroidectomy, the dose of PSL was tapered to 2 mg/day, and neither the AOSD-like manifestations nor the PTC relapsed. On confirming a diagnosis of AOSD, it may be necessary to consider the presence of an associated malignancy, including solid tumors such as PTC.
机译：一名68岁的日本男子因高烧突然发作并伴有关节痛，肌痛，喉咙痛，黄斑疹和肝功能不全而入院。在这些症状发作前六个月，出乎意料的是，18F-氟-脱氧-葡萄糖正电子发射断层扫描/计算机断层扫描（18FFDG PET / CT）意外地发现了三个钙化的甲状腺病变，而没有摄取18F-FDG。在本病发作前两个月，超声引导下的细针穿刺抽吸术已诊断出乳头状甲状腺癌（PTC）。风湿病出现后不久，随后的18F-FDG PET / CT扫描不仅显示了与先前扫描相同的三个甲状腺病变，而且还显示了甲状腺病变中18FFDG的摄取。作出了与PTC相关的成年性斯蒂尔氏病（AOSD）样表现的诊断，并用40 mg /天的泼尼松龙（PSL）治疗迅速缓解了症状。 PSL逐渐变细，没有复发（AOSD）样表现。 PSL治疗开始五个月后，当患者以18 mg / day的PSL剂量进行全甲状腺切除术，然后进行131I甲状腺消融治疗。甲状腺切除术后七个月，PSL的剂量逐渐减少至2 mg / day，并且既没有AOSD样表现也没有PTC复发。在确认AOSD的诊断后，可能有必要考虑相关恶性肿瘤的存在，包括实体瘤（如PTC）。

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