Enfermedad de Still del adulto, un reto diagnóstico

The adult Still's disease is an inflammatory disease of unknown etiology. It is characterized by the triad of intermittent high fever, arthralgia or arthritis and evanescent rash, maximum during fever spikes. In this triad can be added numerous systemic manifestations, some of which can compromise the vital prognosis. Laboratory tests show a marked inflammatory syndrome and polymorphonuclear neutrophil leukocytosis. The presence of hyperferritinemia as great value to guide the diagnosis. Immunological tests are normal, except for frequent hypergammaglobulinemia. Infectious negative studies. The evolution of the disease is highly variable. Most patients require treatment with corticosteroids, sometimes in combination with methotrexate. Biological treatments including inhibitors of interleukin 1 and interleukin 6 occupy a prominent place. We present a case of long duration, multidisciplinary, difficult diagnosis, which originated to the patient great suffering and limitation of their social and working life, with marked disability. The diagnosis and treatment of disease has offered to the patient great relief for the possibility to improve their symptoms and anxiety for an undiagnosed disease.