Journal of Clinical Case Reports

Transformation of Rheumatoid Arthritis to Adult Still’s Disease

Abstract

Rozin AP, Naffaa ME, Markovits D and Hayek T

Adult Onset Still’s Disease (AOSD) commonly affects young people. We observed an elderly woman with long standing seronegative rheumatoid arthritis and further transformation to systemic illness. A 74 year old woman was admitted to emergency room with multiple joints pain and rash, associated with a fever 40.5°C. The patient had a long standing rheumatoid arthritis presented as symmetric polyarthritis and treated with prednisone only. Multiple immunosuppressive and biological medications failed and she developed several severe bacteremia events. Her past ferritin levels were normal, except for a single elevation two years before.