Advertisement

Clinical Rheumatology

, Volume 25, Issue 5, pp 639–644 | Cite as

A multicenter study of patients with adult-onset Still’s disease compared with systemic juvenile idiopathic arthritis

  • Ankara Rheumatology Study Group
  • Salih PayEmail author
  • Nuran Türkçapar
  • Mukaddes Kalyoncu
  • İsmail Şimşek
  • Esin Beyan
  • İhsan Ertenli
  • M. Akif Öztürk
  • Nurşen Düzgün
  • Hakan Erdem
  • Zeynep Özbalkan
  • Sedat Kiraz
  • Gülay Kınıklı
  • Nesrin Besbas
  • Ayhan Dinç
  • Aşkın Ateş
  • Ümit Ölmez
  • Meral Çalgüneri
  • Olcay Tiryaki Aydıntuğ
  • Ayşin Bakkaloğlu
  • Mustafa Turan
  • Murat Turgay
  • Yaşar Karaaslan
  • Rezzan Topaloğlu
  • Murat Duman
  • Seza Özen
Original Article

Abstract

Adult-onset Still’s disease (AOSD) has often been regarded as the adult spectrum of systemic juvenile idiopathic arthritis (sJIA). The present study aims to compare the clinical and laboratory features, the disease course and the response to treatment in patients having AOSD with those having sJIA. Retrospective review of all available data that were filled out by adult and paediatric rheumatologists from six centers using a standard data extraction form was performed. A total of 95 patients with AOSD and 25 patients with sJIA were recruited for the study. The frequency of fever, rash, myalgia, weight loss and sore throat was higher in patients with AOSD. The pattern of joint involvement differed slightly. Laboratory findings were similar in both groups, except that liver dysfunction and neutrophilia were more common among adults. A multiphasic pattern dominated the childhood cases, whereas the most frequent course was a chronic one in adults. Corticosteroids and methotrexate were the most commonly employed therapy; however, chloroquine was another popular therapy in the adult group. We showed a difference in the rate of clinical and laboratory features between patients with AOSD and those with sJIA. AOSD and sJIA may still be the same disease, and children may simply be reacting differently as the result of the first encounter of the putative antigens with the immune system.

Keywords

Adult-onset Still’s disease Systemic juvenile idiopathic arthritis 

References

  1. 1.
    Petty RE, Southwood TR, Baum J, Bhettay E, Glass DN, Manners P et al (1998) Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol 25:1991–1994PubMedGoogle Scholar
  2. 2.
    Bywaters EG (1971) Still’s disease in the adult. Ann Rheum Dis 30:121–133PubMedGoogle Scholar
  3. 3.
    Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H et al (1992) Preliminary criteria for classification of adult Still’s disease. J Rheumatol 19:424–430PubMedGoogle Scholar
  4. 4.
    Tanaka S, Matsumoto Y, Ohnishi H, Maeda M, Nishioka K, Kashiwazaki S et al (1991) Comparison of clinical features of childhood and adult onset Still’s disease. Ryumachi 31:511–518PubMedGoogle Scholar
  5. 5.
    Uppal SS, Pande IR, Kumar A, Kailash S, Sekharan NG, Adya CM et al (1995) Adult onset Still’s disease in northern India: comparison with juvenile onset Still’s disease. Br J Rheumatol 34:429–434PubMedCrossRefGoogle Scholar
  6. 6.
    Luthi F, Zufferey P, Hofer MF, So AK (2002) Adolescent-onset Still’s disease: characteristics and outcome in comparison with adult-onset Still’s disease. Clin Exp Rheumatol 20:427–430PubMedGoogle Scholar
  7. 7.
    Cabane J, Michon A, Ziza JM, Bourgeois P, Bletry O, Godeau P et al (1990) Comparison of long term evolution of adult onset and juvenile onset Still’s disease, both followed up for more than 10 years. Ann Rheum Dis 49:283–285PubMedCrossRefGoogle Scholar
  8. 8.
    Lin SJ, Chao HC, Yan DC (2000) Different articular outcomes of Still’s disease in Chinese children and adults. Clin Rheumatol 19:127–130CrossRefPubMedGoogle Scholar
  9. 9.
    Kawashima M, Yamamura M, Taniai M, Yamauchi H, Tanimoto T, Kurimoto M et al (2001) Levels of interleukin-18 and its binding inhibitors in the blood circulation of patients with adult-onset Still’s disease. Arthritis Rheum 44:550–560CrossRefPubMedGoogle Scholar
  10. 10.
    Sugiura T, Kawaguchi Y, Harigai M, Terajima-Ichida H, Kitamura Y, Furuya T et al (2002) Association between adult-onset Still’s disease and interleukin-18 gene polymorphisms. Genes Immun 3:394–399CrossRefPubMedGoogle Scholar
  11. 11.
    Maeno N, Takei S, Nomura Y, Imanaka H, Hokonohara M, Miyata K (2002) Highly elevated serum levels of interleukin-18 in systemic juvenile idiopathic arthritis but not in other juvenile idiopathic arthritis subtypes or in Kawasaki disease. Arthritis Rheum 46:2539–2541CrossRefPubMedGoogle Scholar
  12. 12.
    Sobieska M, Fassbender K, Aeschlimann A, Bourgeois P, Mackiewicz S, Muller W (1998) Still’s disease in children and adults: a distinct pattern of acute-phase proteins. Clin Rheumatol 17:258–260CrossRefPubMedGoogle Scholar
  13. 13.
    Cush JJ, Leibowitz IH, Friedman SA (1985) Adult-onset Still’s disease and inflammatory orbital pseudotumor. N Y State J Med 85:110–111PubMedGoogle Scholar
  14. 14.
    Mert A, Ozaras F, Tabak F, Bilir M, Ozturk R, Ozdogan H et al (2003) Fever of unknown origin: a review of 20 patients with adult-onset Still’s disease. Clin Rheumatol 22:89–93CrossRefPubMedGoogle Scholar
  15. 15.
    Husni ME, Maier AL, Mease PJ, Overman SS, Fraser P, Gravallese EM et al (2002) Etanercept in the treatment of adult patients with Still’s disease. Arthritis Rheum 46:1171–1176CrossRefPubMedGoogle Scholar
  16. 16.
    Vignes S, Wechsler B, Amoura Z, Papo T, Frances C, Huong DL et al (1998) Intravenous immunoglobulin in adult Still’s disease refractory to non-steroidal anti-inflammatory drugs. Clin Exp Rheumatol 16:295–298PubMedGoogle Scholar
  17. 17.
    Cavagna L, Caporali R, Epis O, Bobbio-Pallavicini F, Montecucco C (2001) Infliximab in the treatment of adult Still’s disease refractory to conventional therapy. Clin Exp Rheumatol 19:329–332PubMedGoogle Scholar
  18. 18.
    Pirildar T (2003) Treatment of adult-onset Still’s disease with leflunomide and chloroquine combination in two patients (letter). Clin Rheumatol 22:157CrossRefPubMedGoogle Scholar
  19. 19.
    Quartier P, Taupin P, Bourdeaut F, Lemelle I, Pillet P, Bost M et al (2003) Efficacy of etanercept for the treatment of juvenile idiopathic arthritis according to the onset type. Arthritis Rheum 48:1093–1101CrossRefPubMedGoogle Scholar
  20. 20.
    Minden K, Niewerth M, Listing J, Biedermann T, Bollow M, Schontube M et al (2002) Long-term outcome in patients with juvenile idiopathic arthritis. Arthritis Rheum 46:2392–2401CrossRefPubMedGoogle Scholar
  21. 21.
    Besbas N, Saatci U, Bakkaloglu A, Ozen S (1992) Amyloidosis of juvenile chronic arthritis in Turkish children. Scand J Rheumatol 21:257–259PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2005

Authors and Affiliations

  • Ankara Rheumatology Study Group
  • Salih Pay
    • 1
    • 7
    Email author
  • Nuran Türkçapar
    • 2
  • Mukaddes Kalyoncu
    • 3
  • İsmail Şimşek
    • 1
  • Esin Beyan
    • 4
  • İhsan Ertenli
    • 5
  • M. Akif Öztürk
    • 6
  • Nurşen Düzgün
    • 2
  • Hakan Erdem
    • 1
  • Zeynep Özbalkan
    • 4
  • Sedat Kiraz
    • 5
  • Gülay Kınıklı
    • 2
  • Nesrin Besbas
    • 3
  • Ayhan Dinç
    • 1
  • Aşkın Ateş
    • 4
  • Ümit Ölmez
    • 2
  • Meral Çalgüneri
    • 5
  • Olcay Tiryaki Aydıntuğ
    • 2
  • Ayşin Bakkaloğlu
    • 3
  • Mustafa Turan
    • 6
  • Murat Turgay
    • 2
  • Yaşar Karaaslan
    • 4
  • Rezzan Topaloğlu
    • 3
  • Murat Duman
    • 2
  • Seza Özen
    • 3
  1. 1.Division of RheumatologyGulhane Military School of MedicineAnkaraTurkey
  2. 2.Division of Immunology and RheumatologyAnkara University School of MedicineAnkaraTurkey
  3. 3.Department of PediatricsHacettepe University School of MedicineAnkaraTurkey
  4. 4.Department of Internal MedicineAnkara Numune Training and Research HospitalAnkaraTurkey
  5. 5.Division of RheumatologyHacettepe University School of MedicineAnkaraTurkey
  6. 6.Division of RheumatologyGazi University School of MedicineAnkaraTurkey
  7. 7.GATA Romatoloji BDAnkaraTurkey

Personalised recommendations