A case of adult still disease

WangLi,  female,  28-year old,  Married, Nov. 02, 2007.

Case information: Acute onset of skin rash, high fever, wandering joint pain in March, 2006. Misdiagnosis is urticaria, hospitalization for 1 month in local hospital; she took prednisone to develop symptoms.

Recurrence in July, 2006. hospitalization for 1 week in local hospital. She took prednisone again, 8 tablets per day (5mg/tablet). And skin rash concentrated on chest and limbs.

She came to Wangjing Hospital to ask TCM treatment on Nov. 02, 2007.

Main symptoms: not severe joint pain. Taking Prednisone 3 tablets per day (5mg/tablet). Low fever, white, thick and sticky tongue fur, skin is dry and itch, lower limbs pain; thin, slippery and fast pulse.

Syndrome differentiation: 

The main symptoms of adult still disease are high fever, skin rash, wandering joint pain, WBC increasing obviously. In TCM, adult still disease pertains to fever, obstructive syndrome or rash. This patient has taken excessive prednisone for misdiagnosis, so hiding the main syndrome. She is Yin exhausted, plus damp and heat toxin, blood stasis.

Prescription: nourish Yin, clear damp-heat and detoxification. Stopping prednisone slowly.

Patent medicine: Baishao Zhonggan.

Clearing damp-heat: Zhimu, Huangbai,

Nourishing Yin: Xuanshen, Maidong, Shengdi.

Clear blood stasis and promoting blood circulation: Danggui, Chuanxiong, Chishao, Jianghuang.

For lower limbs obstruction: Duzhong.

Stopping itch: Baixianpi.

Detoxification: Pugongying, Lianqiao.

Medboo
 

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