OBJECTIVE: To describe the onset, clinical features, prognostic factors, and treatment of adult-onset Still's disease (AOSD) in cases from China. METHODS: Sixty-one Chinese patients with AOSD were analyzed retrospectively. RESULTS: Common clinical features were fever (100.0%), rash (88.5%), and arthritis (82.0%). The laboratory findings were as follows: leukocytosis (83.6%), increased erythrocyte sedimentation rate (100.0%), elevated transaminase concentrations (23.0%), elevated ferritin levels (79.6%), negative antinuclear antibody (88.5%), and negative rheumatoid factor (88.5%). Of the 61 patients, 44.3% exhibited a monocyclic disease pattern, 29.5% experienced disease relapse at least once, 16.4% exhibited chronic articular course, and 9.8% died; most deaths were due to pulmonary infection and respiratory failure. Based on the disease course, we divided the 61 patients into 2 groups: those with favorable outcome (cyclic disease course, n = 45) and unfavorable outcome (chronic disease course or death, n = 16). We analyzed the prognostic factors for the 2 groups, and found that pleuritis, interstitial pneumonia, elevated ferritin levels, and failure of fever to subside after 3 days of prednisolone at 1 mg/kg/day were unfavorable prognostic factors for patients with AOSD. CONCLUSION: Patients with AOSD had complex symptoms with no specific laboratory findings. Our results indicate that AOSD is not a relatively benign disease, especially in cases that are refractory to high doses of prednisone.
OBJECTIVE: To describe the onset, clinical features, prognostic factors, and treatment of adult-onset Still's disease (AOSD) in cases from China. METHODS: Sixty-one Chinese patients with AOSD were analyzed retrospectively. RESULTS: Common clinical features were fever (100.0%), rash (88.5%), and arthritis (82.0%). The laboratory findings were as follows: leukocytosis (83.6%), increased erythrocyte sedimentation rate (100.0%), elevated transaminase concentrations (23.0%), elevated ferritin levels (79.6%), negative antinuclear antibody (88.5%), and negative rheumatoid factor (88.5%). Of the 61 patients, 44.3% exhibited a monocyclic disease pattern, 29.5% experienced disease relapse at least once, 16.4% exhibited chronic articular course, and 9.8% died; most deaths were due to pulmonary infection and respiratory failure. Based on the disease course, we divided the 61 patients into 2 groups: those with favorable outcome (cyclic disease course, n = 45) and unfavorable outcome (chronic disease course or death, n = 16). We analyzed the prognostic factors for the 2 groups, and found that pleuritis, interstitial pneumonia, elevated ferritin levels, and failure of fever to subside after 3 days of prednisolone at 1 mg/kg/day were unfavorable prognostic factors for patients with AOSD. CONCLUSION:Patients with AOSD had complex symptoms with no specific laboratory findings. Our results indicate that AOSD is not a relatively benign disease, especially in cases that are refractory to high doses of prednisone.
Authors: Jurgen Sota; Antonio Vitale; Antonella Insalaco; Paolo Sfriso; Giuseppe Lopalco; Giacomo Emmi; Marco Cattalini; Raffaele Manna; Rolando Cimaz; Roberta Priori; Rosaria Talarico; Ginevra de Marchi; Micol Frassi; Romina Gallizzi; Alessandra Soriano; Maria Alessio; Daniele Cammelli; Maria Cristina Maggio; Stefano Gentileschi; Renzo Marcolongo; Francesco La Torre; Claudia Fabiani; Serena Colafrancesco; Francesca Ricci; Paola Galozzi; Ombretta Viapiana; Elena Verrecchia; Manuela Pardeo; Lucia Cerrito; Elena Cavallaro; Alma Nunzia Olivieri; Giuseppe Paolazzi; Gianfranco Vitiello; Armin Maier; Elena Silvestri; Chiara Stagnaro; Guido Valesini; Marta Mosca; Salvatore de Vita; Angela Tincani; Giovanni Lapadula; Bruno Frediani; Fabrizio De Benedetti; Florenzo Iannone; Leonardo Punzi; Carlo Salvarani; Mauro Galeazzi; Rossella Angotti; Mario Messina; Gian Marco Tosi; Donato Rigante; Luca Cantarini Journal: Clin Rheumatol Date: 2018-05-17 Impact factor: 2.980
Authors: Jin Shang; Libo Yan; Lingyao Du; Lingbo Liang; Qiaoling Zhou; Tao Liang; Lang Bai; Hong Tang Journal: Wien Klin Wochenschr Date: 2017-01-16 Impact factor: 2.275