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Case report
Adult-onset Still’s disease with concurrent thrombotic thrombocytopenic purpura: case report and literature review
  1. Ryohei Kato1,
  2. Tomoyuki Ikeuchi2,
  3. Katsuyuki Tomita2 and
  4. Akira Yamasaki1
  1. 1Division of Respiratory Medicine and Rheumatology, Department of Multidisclplinary Internal Medicine, Faculty of Medicine, Tottori University Hospital, Yonago, Tottori, Japan
  2. 2Department of Respiratory Medicine, Yonago Medical Centre, National Hospital Organisation Yonago Medical Center, Yonago, Tottori, Japan
  1. Correspondence to Dr Akira Yamasaki; yamasaki{at}


Thrombotic thrombocytopenic purpura (TTP) is rare complication resulting from adult-onset Still’s disease (AOSD). We report the case of a 69-year-old Japanese man who initially presented with fever and joint pain and was diagnosed as having concurrent AOSD with TTP 1 month later. He had extremely high ferritin levels (32 696 ng/mL). He initially responded to plasma exchange but subsequently died of septic shock. AOSD accompanied by extremely high ferritin levels might be considered a sign of concurrent TTP.

  • thrombotic thrombocytopenic purpura
  • rheumatology

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  • Contributors RK and TI drafted the manuscript and contributed to inpatietn cere. KT and AY edited the manuscript and reviesed critically. KT and AY also contributed to inpatient care. All the authors approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.