Clinical Features and Prognosis of Adult-onset Still's Disease: 61 Cases from China

To describe the onset, clinical features, prognostic factors, and treatment of adult-onset Still's disease (AOSD) in cases from China. Sixty-one Chinese patients with AOSD were analyzed retrospectively. Common clinical features were fever (100.0%), rash (88.5%), and arthritis (82.0%). The labor...

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Bibliographic Details
Published in:Journal of rheumatology 2009-05, Vol.36 (5), p.1026-1031
Main Authors: TING ZENG, ZOU, Yu-Qiong, WU, Mei-Fang, YANG, Cheng-De
Format: Article
Language:English
Subjects:
Adult
Arthritis - etiology
Arthritis - pathology
Asian Continental Ancestry Group
Biological and medical sciences
Blood Sedimentation
Cause of Death
China - epidemiology
Diseases of the osteoarticular system
Exanthema - etiology
Exanthema - pathology
Female
Fever - complications
Fever - pathology
Humans
Inflammatory joint diseases
Leukocytosis - etiology
Leukocytosis - pathology
Male
Medical sciences
Middle Aged
Predictive Value of Tests
Prednisone - therapeutic use
Prognosis
Retrospective Studies
Risk Factors
Still's Disease, Adult-Onset - complications
Still's Disease, Adult-Onset - drug therapy
Still's Disease, Adult-Onset - mortality
Still's Disease, Adult-Onset - pathology
Survival Rate
Treatment Failure
Young Adult
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Summary:To describe the onset, clinical features, prognostic factors, and treatment of adult-onset Still's disease (AOSD) in cases from China. Sixty-one Chinese patients with AOSD were analyzed retrospectively. 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. 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.
ISSN:0315-162X
1499-2752
DOI:10.3899/jrheum.080365