biochimica clinica

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CASI CLINICI – Case Reports

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Biochimica Clinica 2015; 39(5) e10-e12

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Caso atipico di orticaria

AUTORI

Mariela Marinova1, Mitja Nabergoj2, Carlo Artusi1, Silvia Baggio1, Laura Brugnolo1, Martina Zaninotto1, Mario Plebani1,3
1U.O. Medicina di Laboratorio, Azienda Ospedaliera - Università degli Studi di Padova
2U.O. Ematologia e Immunologia Clinica, Azienda Ospedaliera di Padova
3Dipartimento di Medicina, Università degli Studi di Padova

ABSTRACT

A case of atypical urticaria

Adult onset Still’s disease (AOSD) is a rare clinical entity with unknown etiology and pathogenesis, characterized by high spiking fevers, arthritis, typical evanescent, nonpruritic, macular and salmon
coloured rash, and multiorgan involvement. AOSD remains a diagnostic challenge due to the overlapping features with numerous infective, neoplastic and rheumatological conditions. A case of AOSD with atypical cutaneous manifestations in a 50-year-old female is reported. The patient’s symptoms included: remittent fever, widespread urticarial, maculopapular erythema and a sore throat. Hematological investigations showed leukocytosis with neutrophilia. There were markedly elevated levels of serum ferritin (20.920 μg/L) and mild liver dysfunction. A glycosylated ferritin assay was performed because of a severe hyperferritinemia, showing a reduction of the glycosylated fraction (<20%), a newly proposed diagnostic criteria for AOSD. We emphasize the diagnostic value of low glycosylated ferritin concentration for the differential diagnosis of this rare disease, particularly in case of atypical presentation.

BIBLIOGRAFIA