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Publications

Case Reports Journal Article Epublish

PubMed: 40255663 DOI: 10.2147/JIR.S509898

Fatal Acute Intestinal Obstruction with Hemophagocytic Lymphohistiocytosis and Multiple Organ Failure in Adult-Onset Still's Disease: A Rare Case Report.

J Inflamm Res 18:5161-5171

Authors: Kun Li, Xuejia Pan, Hongyu Guo, Saiping Jiang, Xueling Fang

Affiliations

  • Department of Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.
  • Department of Nursing, Hangzhou Xiaoying Community Health Service Center, Hangzhou, Zhejiang Province, People's Republic of China.
  • Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.
  • Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.

Abstract

Background

Adult-onset Still's disease (AOSD) is a systemic autoinflammatory disorder characterized by unpredictable multi-organ involvement. Although gastrointestinal complications are uncommon in AOSD, they can be life-threatening and present significant diagnostic and management challenges.

Case Summary

We report the case of a 68-year-old man with AOSD who developed acute intestinal obstruction, a rare and critical complication. Imaging revealed significant colonic wall thickening, with a maximum thickness of 2.6 cm on contrast-enhanced computed tomography. The clinical status of the patient deteriorated, further complicated by the onset of hemophagocytic lymphohistiocytosis (HLH) and multi-organ failure, including acute renal dysfunction. Despite receiving intensive care and aggressive treatment, including supportive measures and immunosuppressive therapy, the patient succumbed to his illness.

Conclusion

This case underscores the importance of recognizing rare gastrointestinal and systemic complications in patients with AOSD. Early identification and prompt multidisciplinary management of conditions such as HLH and acute intestinal obstruction are essential for improving outcomes in such critical scenarios.

MeSH

Intestinal Obstruction, Multiple Organ Failure, Multiple Chronic Conditions, Critical Care, Autoimmune Diseases, Therapeutics, Lymphohistiocytosis, Hemophagocytic, Still'S Disease, Adult-Onset, Macrophage Activation Syndrome