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A case of fever of unknown origin with hyponatremia and literature review

ZHANG Lizhu;YANG Lei;HUANG Qiang;CAO Jianing;CHEN Ying;HAN Zhijun;REN Tianli;YANG Chengjian;Department of Cardiology, Wuxi Second People's Hospital, Nanjing Medical University;Department of Laboratory Medicine, Wuxi Second People's Hospital, Nanjing Medical University;Department of Rheumatism, Wuxi Second People's Hospital, Nanjing Medical University;  
Objective: To investigate the clinical features and differential diagnosis of adult-onset Still's disease and improve its diagnostic accuracy. Methods: The clinical data including pathogenesis, examination index and treatment course of a case of fever of unknown origin with hyponatremia were retrospectively analyzed. Results: According to the clinical manifestation such as long term fever(≥39 ℃), arthralgia lasting ≥2 weeks, leukocytosis, liver dysfunction, sore throat and negative RF and negative ANA, the diagnosis of adult-onset Still's disease was established. Conclusion: The clinical features and laboratory findings of adult-onset Still's disease are not specific, yet it is more difficult when associated with other clinical symptoms.When adult-onset Still's disease is ruled out in a patient with fever of unknown origin, clinical manifestations are the main basis, in addition it is necessary to exclude other disease.
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