ABSTRACT
Adult-onset Still's disease (AOSD) is a rare autoinflammatory disease that typically presents with a triad of fever, evanescent rash, and arthritis. There is often a delay in diagnosis of AOSD due to its nonspecific clinical presentation, which may mimic other infectious, rheumatological disorders, and malignancies. Corticosteroids have been the cornerstone for the management of AOSD for the past many years. However, with the expanding understanding of its pathogenesis, novel therapeutic options targeting various cytokines are being increasingly recognized. Herein, we present a case of AOSD that was successfully treated with tocilizumab, a monoclonal antibody against the interleukin-6 (IL-6) receptor. For the purpose of this article, we also conducted a literature search to review the current therapeutic options available for the treatment of AOSD.
ABSTRACT
May-Thurner syndrome (MTS) is the result of compression of the left common iliac vein between the right common iliac artery and the fifth lumbar vertebra which presents clinically as left lower extremity deep vein thrombosis. MTS is estimated to be present in 2% to 5% of patients undergoing evaluation for lower extremity venous disorders. The antiphospholipid syndrome (aPL) is a disorder in which patients have thrombotic manifestations and/or recurrent spontaneous pregnancy loss associated with laboratory evidence of autoantibodies that recognize anionic phospholipid-protein complexes. We describe a case of a young female who presented with extensive left leg DVT and was found to have May-Thurner syndrome based on the anatomy of her vessels. The hypercoagulable work up was positive for aPL. Catheter-directed thrombolytic therapy is an effective method for restoring venous patency. The underlying left common iliac vein lesion invariably needs stent placement to maintain long term patency.
