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Paras Hospitals, Gurgaon highlights rare case of Adult Onset Still’s disease in a 23-year-old patient

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A UK-based young man of Indian origin was successfully treated at leading mutli-specialty healthcare provider Paras Hospitals, Gurgaon. He was admitted in critical condition with unresponsive high grade fever and was diagnosed with Adult Onset Still’s disease, a rare auto-immune disorder that occurs in 1 in 10 lakh people.Paras-Hospitals

23-year-old Ashish (name changed) was brought to Paras Hospitals, Gurgaon. He was suffering from high grade fever, he exhibited various symptoms such as skin rashes, sweating, joint pain, abdominal pain over ensuing weeks. When in the UK, Ashish did consult his local doctors and was also seen at hospital in London where he was prescribed medicines for flu. With no signs of recovery, Ashish decided to come to India and consulted few doctors. However, when his symptoms did not improve he decided to be admitted to Paras Hospitals, Gurgaon.

Following hospitalization, the doctors wasted no time in conducting relevant tests for every and any possible disease may cause for fever such as Malaria, Pneumonia, Dengue, Swine Flu and likewise. However, all tests ended with negative results. Patient was then referred to Dr. Indrajit Agrawal, HOD, Rheumatology, Paras Hospital, Gurgaon owing to the complaints of joint pains. Further examination and investigations by the doctor revealed Ashish having very high ferritin level that prompted the diagnosis of AOSD.

“Ashish was brought to us after he had suffered non curable fever for at least 2 months. His condition was further worrying as he kept on deteriorating. Since the disease is a very rare one, this requires a high degree of suspicion. The disease was diagnosed under Yamaguchi criteria that has the highest sensitivity,” said Dr Indrajit Agrawal, HOD, Rheumatology, Paras Hospitals.

Upon diagnosis, Ashish was found to have very high Ferretin Level at 18,000 against normal of 150. AODS being an auto immune disorder, he was treated with Actemra (Interleukin 6 inhibitor), which is a biologic modifier and other immunosuppressant.

“Ashish was kept in the hospital for 3 weeks during which period he was given utmost care and concern. We treated him with Actemra, which has been recently approved for AOSD. We were pleased to see Ashish respond positively to the prescribed treatment. The medicine not only controlled his persistent fever but also helped him recover from the disease. Ashish was discharged from hospital after he was completely asymptomatic,” added Dr Agrawal.

Auto-immune disorders are a mal-functioning of the human body’s immune system. In an afflicted person, the body’s immune system (designed to attack foreign invasion of infections) malfunctions and turns against the body’s own healthy cells.

In case of rare disorders such as AOSD, there are handful of cases and which is the prime reason for delayed diagnosis. This makes treatment of such disease a little difficult at an early stage, and requires a lot of medical acumen on the part of the specialists.

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