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Zeitschrift für Rheumatologie

, 67:415 | Cite as

Der adulte Morbus Still

  • B. MangerEmail author
CME Weiterbildung • Zertifizierte Fortbildung
  • 214 Downloads

Zusammenfassung

Der adulte M. Still ist eine seltene, febrile, rheumatische Systemerkrankung mit unbekannter Ätiologie, die schubweise intermittierend verläuft und nach Monaten bis Jahren in Remission oder in einen chronischen Verlauf mit z. T. erheblichen Gelenkdestruktionen übergehen kann. Die Prävalenz dieser Erkrankung scheint in den letzten Jahren zuzunehmen, was wohl auf verbesserte diagnostische Möglichkeiten, aber auch auf einen generell höheren Bekanntheitsgrad bei den Ärzten zurückzuführen ist, die Patienten mit „Fieber unklarer Genese“ behandeln. Diese Übersichtsarbeit soll dazu beitragen diese Tendenz zu verstärken, denn neue Erkenntnisse über die pathophysiologische Rolle proinflammatorischer Zytokine bei dieser Erkrankung haben dazu beigetragen, das diagnostische und therapeutische Repertoire in den letzten Jahren erheblich zu erweitern. Ferritin und Interleukin-18 im Serum sind diagnostisch wertvolle Parameter, und die therapeutische Blockade von Interleukin-1, Interleukin-6 und Tumor-Nekrose-Faktor α kann die entzündliche Aktivität der Erkrankung in den meisten Fällen und auch in lebensbedrohlichen Situationen erfolgreich kontrollieren.

Schlüsselwörter

Adulter M. Still Arthritis Zytokine Prognose Therapie 

Adult onset Still’s disease

Abstract

Adult onset Still’s disease is a rare, febrile, multisystem rheumatic disease with unknown etiology, which runs an intermittent course and can either go into remission after months to years or progress to a chronic course with substantial joint destruction. The prevalence of this disease has been increasing in the last decade presumably caused by better diagnostic tools but also by a higher awareness among physicians taking care of patients with “fever of unknown origin”. This review is intended to augment this trend, since research on the role of proinflammatory cytokines in this disease has led to an improved diagnostic and therapeutic repertoire over the last few years. Ferritin and interleukin-18 serum levels are valuable diagnostic parameters and blockade of interleukin-1, interleukin-6, and tumor-necrosis-factor α can effectively control the inflammatory activity of this disease in most cases and also in life-threatening conditions.

Keywords

Adult onset Still’s syndrome Arthritis Cytokines Prognosis Therapy 

Notes

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Beratungs- und Referententätigkeiten für folgende Firmen: Abbott, Essex, Novartis, Roche, UCB, Wyeth.

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Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  1. 1.Medizinische Klinik III, Klinikum der Friedrich-Alexander-UniversitätErlangenDeutschland

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