title: Adult-onset Still's disease in an oriental population: manifestations, course and outcome in 16 patients.
abstract: This retrospective descriptive study aims to characterise and compare the clinical manifestations, course and outcome of 16 Oriental patients with adult-onset Still's disease diagnosed in the last 4 years with published data based on Western populations and another Oriental (Japanese) series. Like the Japanese, we found a female preponderance, an older age at onset, and fewer patients with abdominal pain, myalgia, sore throat and serositis compared to the Western series. A longer delay in diagnosis occurred in patients lacking either arthritis or rash at presentation. Most patients had mild hyponatraemia and 2 patients had overt syndrome of inappropriate anti-diuretic hormone secretion. All patients showed a dissociation of elevated aldolase with normal to low creatine kinase levels. Over 50% relapsed within a year from diagnosis and needed slow-acting anti-rheumatic drugs as steroid-sparing agents. Two were given intravenous pulse cyclophosphamide therapy for progressive pneumonitis. Outcome was generally good with minimal functional impairment and no mortality.
authors.affiliation: Department of Rheumatology and Immunology, Tan Tock Seng Hospital, Singapore.
authors.forename: E
authors.initials: E
authors.lastname: Lim
authors.forename: H H
authors.initials: HH
authors.lastname: Chng
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007564:Japan / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D017678:Sex Distribution; D012846:Singapore / Q000453:epidemiology; D013256:Steroids / Q000627:therapeutic use; D016706:Still's Disease, Adult-Onset / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013256:Steroids