Clinical features and prognosis of adult-onset still's disease: 61 cases from China.
OBJECTIVE
To describe the onset, clinical features, prognostic factors, and treatment of adult-onset Still's disease (AOSD) in cases from China.


METHODS
Sixty-one Chinese patients with AOSD were analyzed retrospectively.


RESULTS
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.


CONCLUSIONS
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.
Zeng
Ting
T
Department of Rheumatology, Renji Hospital, Medical School of Shanghai JiaoTong University, Shanghai, China.
Zou
Yu-Qiong
YQ
Wu
Mei-Fang
MF
Yang
Cheng-De
CD
D000328:Adult; D001168:Arthritis / Q000209:etiology / Q000473:pathology; D044466:Asian People; D001799:Blood Sedimentation; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D005076:Exanthema / Q000209:etiology / Q000473:pathology; D005260:Female; D005334:Fever / Q000150:complications / Q000473:pathology; D006801:Humans; D007964:Leukocytosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016706:Still's Disease, Adult-Onset / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate; D017211:Treatment Failure; D055815:Young Adult
D011241:Prednisone