Reumatologia: pesquisas atuais
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Elevated D-dimers without Disseminated Intravascular Coagulation in a Patient with Adult Onset Still’s Disease: An Indicator for Early Corticosteroid Treatment?

Natalia G Vallianou, Nikos Schizas, Angeliki Papanicolaou, Michalis Angelakos, George Katsikas and Evangelos Kokkinakis

Adult onset Still’s disease (AOSD), is an inflammatory disease characterized by fever, arthritis or arthralgias, muscle pain, pharyngitis, lymphadenopathy, rash and splenomegaly. Fever together with arthralgias and myalgias are reported in >90% of patients with AOSD. Disseminated intravascular coagulation is a very rare disorder, which may accompany severe cases of AOSD, especially in the context of hemophagocytic syndrome. Herein, we describe a patient with elevated d-dimers, but without disseminated intravascular coagulation and without hemophagocytic syndrome, who responded well to early corticosteroid treatment. We propose that isolated elevated d-dimers may be associated with the severity of the disease and may be suggestive of the need for early corticosteroid treatment.