Rare case of lung involvement in a patient with adult Still’s disease
https://doi.org/10.18093/0869-0189-2025-35-5-732-738
Abstract
Adult-onset Still’s disease (AOSD) is a rare polygenic systemic autoinflammatory disease of unknown etiology, characterized by neutrophilic leukocytosis and the absence of rheumatoid factor and antibodies to cyclic citrulline-containing peptide in the blood serum. Lung damage in AOSD is a rare but serious complication. Bronchiolitis, bronchitis, nonspecific interstitial pneumonia, and organizing interstitial pneumonia have been described as patterns of lung damage in AOSD. Pulmonary manifestations of AOSD remain poorly understood. The aim of the article was to demonstrate a clinical case of AOSD, the main manifestation of which was the development of cryptogenic organizing pneumonia with respiratory failure. The article presents in detail the stages of the diagnostic search. An interesting feature of this clinical case was the absence of the most common symptoms of AOSD (sore throat, arthritis/arthralgia). Conclusion. This clinical case emphasizes the importance of clinicians’ awareness of possible pulmonary complications in AOSD.
About the Authors
O. V. TeplyakovaRussian Federation
Olla V. Teplyakova, Doctor of Medicine, Professor of the Department of Polyclinic Therapy; Head of the Clinical Rheumatology
ul. Repina 3, Ekaterinburg, 620028, tel.: (912) 242-26-58
ul. Zavodskaya 29, Ekaterinburg, 620109
Competing Interests:
The authors declare no conflict of interest.
I. V. Leshchenko
Russian Federation
Igor V. Leshсhenko, Doctor of Medicine, Professor; Professor, Department of Infectious Diseases, Phthisiology and Pulmonology; Chief Researcher; Scientific Director; Chief Freelance Pulmonologist, Healthcare Ministry of the Sverdlovsk Region, Honored Doctor of the Russian Federation
ul. Repina 3, Ekaterinburg, 620028, tel.: (912) 288-28-23
ul. Zavodskaya 29, Ekaterinburg, 620109
ul. 22-go Parts’ezda 50, Ekaterinburg, 620039
Competing Interests:
The authors declare no conflict of interest.
Yu. E. Batrudinova
Russian Federation
Yulia. E. Batrudinova, Pulmonologist
ul. Zavodskaya 29, Ekaterinburg, 620109, tel.: (912) 950-547-58-63
Competing Interests:
The authors declare no conflict of interest.
E. Z. Eidlina
Russian Federation
Elena Z. Eydlina, Radiologist
ul. Zavodskaya 29, Ekaterinburg, 620109, tel.: (912) 264-14-40
Competing Interests:
The authors declare no conflict of interest.
O. G. Tsvetkova
Russian Federation
Olga G. Tsvetkova, Rheumatologist
ul. Zavodskaya 29, Ekaterinburg, 620109, tel.: (922) 152-71-89
Competing Interests:
The authors declare no conflict of interest.
A. V. Krivonogov
Russian Federation
Alexey V. Krivonogov, Pulmonologist
ul. Zavodskaya 29, Ekaterinburg, 620109, tel.: (922) 203-18-99
Competing Interests:
The authors declare no conflict of interest.
S. M. Chapurina
Russian Federation
Svetlana M. Chapurina, Deputy Director General for Clinical Expertise Work
ul. Zavodskaya 29, Ekaterinburg, 620109, tel.: (912) 264-43-85
Competing Interests:
The authors declare no conflict of interest.
References
1. Kimura Y., Weiss J.E., Haroldson K.L. e al. Childhood arthritis rheumatology research Alliance Carra Net investigators. Pulmonary hypertension and other potentially fatal pulmonary complications in systemic juvenile idiopathic arthritis. Arthritis Care Res. (Hoboken). 2013; 65 (5): 745–752. DOI: 10.1002/acr.21889.
2. Saper V.E., Chen G., Deutsch G.H. et al. Emergent high fatality lung disease in systemic juvenile arthritis. Ann. Rheum. Dis. 2019; 78 (12): 1722–1731. DOI: 10.1136/annrheumdis-2019-216040.
3. Schulert G.S., Yasin S., Carey B. et al. Systemic juvenile idiopathic arthritis-associated lung disease: characterization and risk factors. Arthritis. Rheumatol. 2019; 71 (11): 1943–1954. DOI: 10.1002/art.41073.
4. Nasonov E.L., Feist E. [Adult Still's disease: New horizons]. Nauchno-prakticheskaya revmatologiya. 2021; 59 (6): 645–665. DOI: 10.47360/1995-4484-2021-643-663 (in Russian).
5. Huang Y., Sompii-Montgomery L., Patti J. et al. Disease course, treatments, and outcomes of children with systemic juvenile idiopathic arthritis-associated lung disease. Arthritis Care Res. (Hoboken). 2024; 76 (3): 328–339. DOI: 10.1002/acr.25234.
6. Sato H., Yokoe I., Nishio S. et al. A case of adult onset Still's disease complicated with cryptogenic organizing pneumonia. Intern. Med. 2011; 50 (3): 247–251. DOI: 10.2169/internalmedicine.50.4180.
7. Ak O., Ozer S., Cağ Y., Karagöz G. An adult onset Still's disease mimicking pneumonia. Rheumatol. Int. 2012; 32 (8): 2539–2541. DOI: 10.1007/s00296-010-1445-y.
8. Ruscitti P., Berardicurti O., Iacono D. et al. Parenchymal lung disease in adult onset Still's disease: an emergent marker of disease severity-characterisation and predictive factors from Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort of patients. Arthritis Res. Ther. 2020; 22 (1): 151. DOI: 10.1186/s13075-020-02245-5.
9. Gerfaud-Valentin M., Cottin V., Jamilloux Y. et al. Parenchymal lung involvement in adult-onset Still disease: a STROBE-compliant case series and literature review. Medicine (Baltimore). 2016; 95 (30): e4258. DOI: 10.1097/MD.0000000000004258.
10. Yamaguchi M., Ohta A., Tsunematsu T. et al. Preliminary criteria for classification of adult Still's disease. J. Rheumatol. 1992; 19 (3): 424–430. Available at: https://www.jrheum.org/sites/default/files/pdf/Guides/Yamaguchi_1992_19_424-30%20(1).pdf
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For citations:
Teplyakova O.V., Leshchenko I.V., Batrudinova Yu.E., Eidlina E.Z., Tsvetkova O.G., Krivonogov A.V., Chapurina S.M. Rare case of lung involvement in a patient with adult Still’s disease. PULMONOLOGIYA. 2025;35(5):732-738. (In Russ.) https://doi.org/10.18093/0869-0189-2025-35-5-732-738