Enfermedad de Still del adulto: una gran simuladora: experiencia clínica basada en 20 casos / Adult Still's disease: retrospective review of 20 patients
Rev. méd. Chile
;
137(8): 1010-1016, ago. 2009. ilus
Article
in Spanish
| LILACS
| ID: lil-531990
ABSTRACT
Background:
Adult Still's disease is an inflammatory disorder characterized by quotidian fevers, and an evanescent rash. Its presentation can be acute or subacute.Aim:
To report our experience with Adult Still's disease. Material andmethods:
Systematic retrospective review of medical records of nine men and 11 women aged between 17 and 57 years, with Still's disease, followed in two public hospitals of Metropolitan Santiago.Results:
Eighty percent of patients had a prior different diagnosis. All presented with fever and joint involvement. Eighty percent had malaise, 80 percent had odynophagia, 80 percent had an evanescent rash, 70 percent had myalgias, 50 percent had lymph node enlargement and 40 percent had splenomegaly. Laboratory showed ¡eukocytosis in 80 percent and a high erythrocyte sedimentation rate in all. High ferritin levels were detected in 80 percent, and became an important diagnosis clue. Initial treatment was based on non steroidal antiinflammatory drugs, however 80 percent required steroids and 35 percent required methotrexate. Azathioprine, sulphalazine, hydroxychloroquine and ¡eflunomide were used occasionally. Eleven patients had a single episode, nine had a relapsing disease and four had a chronic or persistent mode.Conclusions:
Adult Still's disease must be suspected in patients with fever of unknown origin. An early diagnosis and adequate treatment of the disease are associated with a favorable evolution and prognosis.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Still's Disease, Adult-Onset
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2009
Type:
Article
Affiliation country:
Chile
/
Colombia
Institution/Affiliation country:
Hospital San Borja Arriarán/CL
/
Hospital San Juan de Dios/CL
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