Adult Still’s disease: clinical experience with 17 cases

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Aim: Adult-onset Still’s disease (AOSD) is a febrile disorder of unknown etiology characterised by typical spiking fever, evanescent rash, arthralgia and leucocytosis. We aimed to investigate the clinical and laboratory features, disease course and outcomes of patients with AOSD. Materials and Methods: Patients diagnosed as AOSD based on Yamaguchi’s criteria between years 2000 and 2011 were enrolled in the study. Clinical features, treatments and prognosis of the patients were retrospectively analyzed. Results: A total of 17 patients (9 woman, 8 men) were included in the study. The mean age at disease onset was 33 years (20–63). Arthralgia (100%), fever (100%), sore throat (76.5%), and rash (76.5%) were the most common clinical findings. We found lymhadenopathy in 47.05 %, splenomegaly in 23.52%, hepatomegaly in 23.52%, pleural effusion in 11.8%, and pericardial effusion in 11.8% of our patients. The median value of laboratory findings were as follows; C-reactive protein level of 15 (8–21) mg/dl, erythrocyte sedimentation rate (ESR) of 98 (75–120) mm/hr, leucocytosis was present in all the patients. Eleven patients had a WBC count ≥ 15.000 /μl. Serum ferritin levels were raised in all of the patients. The median follow-up of the patients was 43 (17–140) months. The median delay in diagnosis was 45 (16-135) days. Self-limited, intermittent and chronic disease course was seen in 12, 3 and 2 patients respectively. Conclusion: The disease course in this study due to the shorter diagnostic delay and early and appropriate treatment was highly benign compared to the previous studies. It is concluded that in the case of early diagnosis and appropriate treatment AOSD is a relatively benign disease

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Adult , onset Still’s disease , clinical fi ndings , laboratory fi ndings , diagnosis

Pamukkale Medical Journal

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Pamukkale Medical Journal