[Still's syndrome in the adult. A report of 8 cases with special reference to diagnostic value of ferritin].
BACKGROUND
Adult onset Still's disease (AOSD) is an uncommon, systemic, inflammatory disorder of unknown etiology, characterized by the triad of fever, arthritis and rash.


RESULTS
We describe 8 cases of AOSD (3 male, 5 female) diagnosed and treated in the Department of Rheumatology from 1980 to 1996. The delay in reaching a firm diagnosis was between 2 and 86 months, due to both lack of specific serum markers and the abundance of possible differential diagnoses. Our therapeutic strategies and results are presented and the value of obtaining serum ferritin levels for both diagnosis and follow-up studies is discussed. The patients data are compared to those of the world's literature on AOSD.


CONCLUSIONS
The differential diagnosis of fever of unknown origin should always include AOSD, because these patients could be spared from invasive and unnecessary diagnostic measures. Increased serum ferritin levels are of particular value in the diagnosis of acute AOSD and the normalization of the serum ferritin value is a reliable indicator of therapeutic success.
Mock
B
B
Klinik für Innere Medizin IV--Nephrologie, Rheumatologie, Osteologie, Pneumologie, Friedrich-Schiller--Universität Jena
Hein
G
G
Stein
G
G
D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D005293:Ferritins / Q000097:blood*; D005335:Fever of Unknown Origin / Q000209:etiology*; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D016706:Still's Disease, Adult-Onset / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D005293:Ferritins; D011239:Prednisolone