Clinical characteristics, treatment, and outcome of adult onset Still's disease in southern Chinese.
OBJECTIVE
To study the clinical characteristics, treatment outcome, and complications of patients with adult onset Still's disease (AOSD) in our local Chinese population.


METHODS
Patients with AOSD were identified among others who attended our rheumatology clinics from 1967 to 1997 and were followed. Their clinical and laboratory features at presentation, treatment, and outcome were recorded and compared with other reported series.


RESULTS
Sixteen patients with AOSD were identified. Eleven (69%) were female. Nine (56%) had onset of the disease between 16 and 35 years of age. The commonest presenting features were fever (100%), arthritis (94%), rash (85%), weight loss (69%), and sore throat (63%). Fifteen patients presented with pyrexia of unknown origin and the median duration of fever before the establishment of the diagnosis was 6 weeks (range 4-75). The acute phase response was marked in all patients with gross elevation of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and complement levels. Hyperferritinemia (> 5 times normal) was present in 90% of cases. Most patients (81%) required corticosteroid therapy and 85% of those steroid treated patients received additional disease modifying agents. The mean duration of followup of our patients was 93.3 months (range 8-362). Five (33%) had monocyclic systemic disease, 6 (40%) had polycyclic systemic disease, and 4 (27%) had frequent relapses that progressed to a chronic arthropathy.


CONCLUSIONS
AOSD in southern Chinese tends to run a benign course, with few patients evolving into chronic inflammatory arthropathy. A significantly lower incidence of serositis, lung involvement, and enlargement of the reticuloendothelial organs was observed at presentation compared with patients of different ethnic origins.
Mok
C C
CC
Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong. ccmok@netvigator.com
Lau
C S
CS
Wong
R W
RW
D000210:Acute-Phase Reaction / Q000150:complications / Q000276:immunology; D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002681:China / Q000208:ethnology; D003480:Cushing Syndrome / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006402:Hematologic Diseases / Q000150:complications; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D006984:Hypertrophy; D007592:Joint Diseases / Q000150:complications; D008107:Liver Diseases / Q000150:complications; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012157:Mononuclear Phagocyte System / Q000473:pathology; D010612:Pharyngitis / Q000150:complications; D012871:Skin Diseases / Q000150:complications; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use; D016706:Still's Disease, Adult-Onset / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D013256:Steroids