Keywords
Macrophage Activation Syndrome
Febrile Syndromes
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Abstract
Objective: To report the case of a hospitalized patient diagnosed with Still's Disease and Macrophage Activation Syndrome. Case detail: Female patient, 17 years old, black, admitted to the Internal Medicine ward with a report of sore throat, oligoarthritis, recurrent fever with an average of 38.5 °C, pruritic hyperchromic spots on the back, upper limbs and abdomen that worsened with a feverish peak for about 30 days, evolving during hospitalization with a convulsive crisis followed by drowsiness, lethargy, with response only to painful stimuli and hypotension. On the tenth day of hospitalization, the patient presented hepatosplenomegaly on physical examination, with no other significant alterations and a complaint of retrograde amnesia. Laboratory tests included anemia, thrombocytopenia, increased transaminases, hypertriglyceridemia, increased serum ferritin and fibrinogen in the amount of 150, fulfilling 5 of the 9 criteria for the diagnosis of Macrophage Activation Syndrome (MAS). Final considerations: Still's disease and Macrophage Activation Syndrome are rare diseases, which imply high morbidity and mortality in the lives of affected patients and are primarily diagnoses of exclusion. This work demonstrates that the diagnosis of febrile syndromes can be a challenge and reiterates the importance of quality care.
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