A child with Still disease develops persistent fever, confusion, platelets 58 × 10⁹/L, fibrinogen 1.2 g/L, triglycerides 3.8 mmol/L and ferritin

Question

A child with Still disease develops persistent fever, confusion, platelets 58 × 10⁹/L, fibrinogen 1.2 g/L, triglycerides 3.8 mmol/L and ferritin 45,000 micrograms/L. What is the immediate priority?

Accepted Answer

Begin urgent specialist treatment for macrophage-activation syndrome

Answer

Start oral iron chelation before reassessing the systemic inflammation

Answer

Await marrow haemophagocytosis before starting anti-inflammatory treatment

Answer

Treat presumed bacterial sepsis alone until every culture is final

Answer

Continue existing Still-disease treatment and repeat ferritin in one week

Kawasaki disease — SCE Rheumatology MCQ

A child with Still disease develops persistent fever, confusion, platelets 58 × 10⁹/L, fibrinogen 1.2 g/L, triglycerides 3.8 mmol/L and ferritin 45,000 micrograms/L. What is the immediate priority?