Abstract
Adult-onset Still's disease (AOSD) was described originally by Eric Bywaters in 1971. AOSD closely resembles systemic-onset juvenile idio-pathic arthritis, a pediatric disorder known originally as Still's disease. An intensely inflammatory, multiorgan system disorder characterized by a polyarthritis, high spiking fevers, and an evanescent, salmon-colored rash (Figs. 3.1a–c). The rash is described as small macules that disappear during the night but reappear the next day, usually coincident with a fever spike. Peripheral joint involvement can be fleeting but also may settle into a refractory, destructive arthritis marked by a tendency in some joints for fusion. AOSD is typically seronegative. Patients do not have rheumatoid factor or antibodies to cyclic citrullinated peptides. Other common features are leukocytosis, thrombocy-tosis, elevations of the serum hepatic aminotransferase concentrations, splenomegaly, and serositis. Pharyngitis is often the initial symptom.
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References
Allantaz F, Chaussabel D, Banchereau J, Pascual V. Microarray-based identification of novel biomarkers in IL-1-medicated diseases. Curr Opin Immunol 2007; 19:623–632
Aptekar RG, Decker JL, Bujak JS, Wolff SM. Adult onset juvenile rheumatoid arthritis. Arthritis Rheum 1973; 16:715–718
Bresnihan B. Cytokine neutralizers: IL-1 inhibitors. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH (eds) Rheumatology (4th edn). Edinburgh, UK, Mosby, 2008, pp. 495–500
Bywaters, EGL. Still's disease in the adult. Ann Rheum Dis 1971; 30:121–132
Esdaile J. Adult Still's disease. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH (eds) Rheumatology (4th edn). Edinburgh, UK, Mosby, 2008, pp. 785–792
Fautrel B, Sibilia J, Mariettte X, et al Tumor necrosis factor alpha blocking agents in refractory adult Still's disease: An observational study of 20 cases. Ann Rheum Dis 2005; 64:262–266
Fitzgerald AA, LeClercq SA, Yan A, et al Rapid responses to anakinra in patients with refractory adult-onset Still's disease. Arthritis Rheum 2005; 52:1794–1803
Husni ME, Maier AL, Mease PJ, et al Etanercept in the treatment of adult patients with Still's disease. Arthritis Rheum 2002; 46:1171–1176
Nguyen KH, Weisman MH. Severe sore throat as a presenting symptom of adult-onset still's disease: A case series and review of the literature. J Rheumatol 1997; 24:592–597
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Weisman, M.H. (2009). Adult-Onset Still's Disease. In: Stone, J.H. (eds) A Clinician's Pearls and Myths in Rheumatology. Springer, London. https://doi.org/10.1007/978-1-84800-934-9_3
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DOI: https://doi.org/10.1007/978-1-84800-934-9_3
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