American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following could be a symptom of adult-onset Still disease?

1. Lower extremity edema

2. High neutrophil counts

3. Pulmonary hypertension

4. Neuropathic pain

The correct answer is: High neutrophil counts

High neutrophil counts can be a symptom of adult-onset Still disease, which is characterized by systemic inflammation. This disease is a type of inflammatory arthritis that typically presents with a combination of fevers, salmon-colored rashes, and joint pain. The inflammatory process in Still's disease often leads to a significant neutrophilic response, resulting in elevated neutrophil counts (neutrophilia) when analyzed through blood tests. This increase in neutrophils is crucial in diagnosing and recognizing the disease, as it reflects the underlying systemic inflammatory state characteristic of Still’s disease. The presence of high neutrophil counts can help differentiate adult-onset Still disease from other types of arthritis that may not show such a marked leukocyte response.