Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website

Case Report

Volume 5, Number 2, April 2013, pages 144-149

Granulomas Formation in Lymph Nodes, Liver and Spleen in Adult-Onset Still’s Disease: A Case Report


Figure 1.
Figure 1. Thoracic and abdominal CT scans from the presented patient: Enlarged mediastinal lymph nodes with a hypodense center (A, B, white arrows), and multiple hypodense splenic (C, white arrow) and hepatic (D, white arrow) lesions were detected.


Table 1. Accordance of the Presented Patient With the Yamaguchi Criteria for the Diagnosis of Adult-Onset Still’s Disease
Yamaguchi criteria (require the presence of five features, with at least two being major diagnostic criteria)Patient’s characteristics
Major Yamaguchi criteria:
  1. Fever of at least 39 °C lasting at least one week.+
  2. Arthralgias or arthritis lasting two weeks or longer.-
  3. Typical rash (maculopapular, nonpruritic) during febrile episodes.-
  4. Leukocytosis (10,000/µL or greater), with at least 80 percent granulocytes.+
Minor Yamaguchi criteria:
  1. Sore throat-
  2. Lymphadenopathy+
  3. Hepatomegaly or splenomegaly+
  4. Abnormal liver function studies-
  5. Negative antinuclear antibodies and rheumatoid factor.+
  1. Infection, especially sepsis and infectious mononucleosis+
  2. Malignancies, especially lymphomas+
  3. Rheumatic diseases known to mimic ASD+