Retrospective study of 61 patients with adult-onset Still’s disease admitted with fever of unknown origin in China

Abstract

Adult-onset Still's disease (AOSD), as a category of connective tissue diseases, has about 5∼9% of fever of unknown origin (FUO) cases. Diagnosis of AOSD was challenging because of its nonspecific characteristics. The present study analyzed clinical manifestations and laboratory findings in a series of patients with AOSD from eastern China. Medical records of 61 patients admitted with FUO and with a discharge diagnosis of AOSD were retrospectively evaluated and analyzed with special focus on clinical manifestations and laboratory findings. Compared with previous reports, most features of our patients had a similar incidence rate. Rash (79%), arthralgia (80%), and sore throat (84%) were the most frequent clinical manifestations in our series. Leukocytosis (80%), elevated ESR (98%) and CRP (100%), negative ANA (90%) and RF (93%), and high ferritin level (94%) were the most sensitive laboratory findings in our patients. AOSD was not a rare reason of FUO in eastern China. Fever, arthralgia, rash, sore throat, leukocytosis, neutrophilia, elevated ESR and CRP, negative ANA and RF, and high ferritin level were the most common clinical features in our series. The lack of highly specific characteristic makes the diagnosis of AOSD difficult compared with other diseases in FUO.

Elderly-onset Still's Disease Complicated by Macrophage Activation Syndrome: A Case Report and Review of the Literature

“…First, we compared the clinical features between the 25 EOSD cases (the present case and the 24 cases from the literature review) and the overall AOSD group (7,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45) (Table 2). The mean onset age was 76.6±4.9 and 24-46 years old in the EOSD and AOSD groups, respectively.…”

Enfermedad de Still del adulto: características clínicas y pronóstico de una cohorte de pacientes colombianos

“…Se encontraron pruebas hepáticas anormales en el 45.2% de la muestra, una frecuencia menor a la reportada por varios autores. 18,[22][23][24] Los ANA y el factor reumatoide suelen ser negativos en pacientes con ESA. 3,5 No obstante, en el presente estudio se observó un porcentaje importante de participantes con resultados positivos a estas pruebas, aunque la mayoría de los que tuvieron positividad fue a títulos bajos, lo que se podría explicar por el comportamiento de este examen en población general.…”

Pneumonitis in Adult Onset Still’s Disease: Uncommon or Under Diagnosed?

“…6 Regarding pneumonitis, and according to the main studies (Table 2), it affects from 1.9% up to 27% of patients. 3,[6][7][8][9][10][11][12][13] This variability may reflect the sample size, the follow-up duration and the distinct demographic characteristics. Described in 27% of the reported cases by Pouchot et al, pulmonary infiltrates are transient, usually associated to pleural effusion, and are frequently located in the lower or upper lobes, as observed in our patient.…”