title: Presentation and diagnosis of adult-onset Still's disease: the implications of current and emerging markers in overcoming the diagnostic challenge.
abstract: Adult-onset Still's disease (AOSD) is a known cause of fever of unknown origin. It is characterized by a triad of symptoms: spiking fever (>39°C), salmon-colored rash and arthritis/arthralgia. On a predisposing genetic background, several conditions may act as trigger for disease and among these, infectious agents are the most important. Nowadays, a dichotomous view of AOSD has been introduced which distinguishes this entity in two subsets according to the clinical features and laboratory aspects: systemic or articular. As AOSD is a diagnosis of exclusion, specific biomarkers able to facilitate differential diagnosis are needed. A number of possible biomarkers have been proposed that will be discussed in detail in this review: ferritin, IL-18, procalcitonin, s100 proteins and sCD163.
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche, Reumatologia, Sapienza Università di Roma, Viale del Policlinico 155, Rome 00161, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Colafrancesco
authors.forename: Roberta
authors.initials: R
authors.lastname: Priori
authors.forename: Guido
authors.initials: G
authors.lastname: Valesini
mesh_terms: D000818:Animals; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D001168:Arthritis / Q000150:complications / Q000175:diagnosis*; D015415:Biomarkers / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide; D003937:Diagnosis, Differential; D005076:Exanthema / Q000150:complications / Q000175:diagnosis*; D005293:Ferritins / Q000378:metabolism; D005334:Fever / Q000150:complications / Q000175:diagnosis*; D020022:Genetic Predisposition to Disease; D006801:Humans; D007239:Infections / Q000150:complications / Q000175:diagnosis*; D020382:Interleukin-18 / Q000378:metabolism; D011498:Protein Precursors / Q000378:metabolism; D011956:Receptors, Cell Surface / Q000378:metabolism; D009418:S100 Proteins / Q000378:metabolism; D016706:Still's Disease, Adult-Onset / Q000150:complications / Q000175:diagnosis*; D000098902:CD163 Antigen
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; C000606589:CALCA protein, human; D000098902:CD163 Antigen; D020382:Interleukin-18; D011498:Protein Precursors; D011956:Receptors, Cell Surface; D009418:S100 Proteins; D002116:Calcitonin; D005293:Ferritins; D015740:Calcitonin Gene-Related Peptide
keywords: AOSD; CD163; adult-onset Still’s disease; ferritin; interleukin-18; procalcitonin; s100A12; s100A8/9