Question 139 · LEK · Still's disease
A 22-year-old male came to the hospital because of recurrent hyperthermia and articular pain in knees and wrists. The maculopapular rash was noted on the skin of the trunk and thighs which caused no itching. Similar signs occurred 3 months ago. He denied taking any drugs or diet supplements. ALT activity was 160 IU/L, AST = 90 IU/L, and ferritin concentration = 750 μg/L (normal values < 200 μg/L). Transferrin saturation was normal. Abdominal ultrasonography showed hepatosplenomegaly. Which of the following is the most probable diagnosis?
- A. Behçet’s disease.
- B. primary sclerosing cholangitis (PSC).
- C. adult-onset Still’s disease.
- D. rheumatoid arthritis.
- E. hereditary haemochromatosis.
Hint
Very high ferritin with normal transferrin saturation points away from iron overload and toward a systemic inflammatory disease.
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