Adult-Onset Still's Disease in India

Abstract

Adult onset Still's disease was provisionally diagnosed in 31 patients from northern India over a period of five years, in 27 of whom the diagnosis was subsequently felt to have been confirmed. This report describes the clinical characteristics of these patients along with the different therapeutic measures used and their response. Adult onset Still's disease should be considered in the differential diagnosis of 'pyrexia of unknown origin'.

Adult-onset still's disease

“…AOSD is a syndrome characterised by the collection of particular symptoms, signs and laboratory parameters and the exclusion of similar entities. The ratios of the presence of these symptoms, signs and laboratory values were found to be reported variously in different series (3,4,6–9).…”

Diagnosis and treatment of adult-onset Still’s disease: a concise summary of the German society of rheumatology S2 guideline

“…However, the use of IL-18 in daily practice is currently limited by the lack of a validated and certified com- 1). Concerning treatment, the use of non-steroidal anti-inflammatory drugs (NSAIDs) in cohort studies [4,24,49,52,66,90,142,171,187,191] has led to their being reported to be sufficiently efficient in a wide range of 7-54% of AOSD cases [4,66,90,142,171,191]. Therefore, NSAIDs can be tried for temporary symptomatic relief [4,24,49,52,66,90,142,171,187,191] (see recommendation 8 in .…”

“…Glucocorticoids have been used as part of the treatment approach in virtually all AOSD studies so far [3, 4, 14, 17, 22, 25-27, 46, 56, 63, 66, 71, 80, 82, 87, 90, 91, 94, 103, 105, 107, 110, 117, 118, 124, 125, 140, 141, 144, 147, 148, 150-153, 158, 163, 166, 168, 170, 176, 182, 187, 190, 191, 193, 196, 199, 203, 205, 207, 208, 210, 215]. Their effectiveness has been reported to be higher than that of NSAIDs, with a range of 38-95% [60,66,67,90,151,171,191], albeit with a high risk of flare after discontinuation [141,144,151]. The use of glucocorticoids is therefore recommended as part of an initial treatment regime in AOSD [3, 4, 7, 14, 17, 22, 25-27, 46, 56, 63, 66, 71, 80, 82, 87, 90, 91, 94, 103, 105, 107, 110, 117, 118, 124, 125, 140, 141, 144, 147, 148, 150-153, 157, 158, 163, 166, 168, 170, 171, 175, 176, 182, 187, 190, 191, 193, 196, 199, 203, 205, 207, 208, 210, 215] (see recommendation 9 in .…”

Adult Onset Still's Disease: A Case Report and Review of Literature

“…Even though >90% patients in series reported from West have this characteristic rash, this has been less reported in studies from India, probably due to difficulty in identifying the rash in 14,15 people with dark skin.…”