ABSTRACT
UNLABELLED: Adult-Onset Still's disease (AOSD) is a rare condition of unknown origin with various presentations and unpredictable outcome. The aim of this study was to analyse clinical and biological presentation, and outcome of patients admitted to an internal medicine service. METHOD: A retrospective cohort design with prospective follow-up was used. All the patients admitted to our internal medicine service for AOSD between January 1998 and March 2004 were included. RESULTS: According to Yamaguchi's classification criteria, 17 patients were analysed with a mean age at onset of 37.3 years and a 2.4 sex-ratio (female/male). Mean follow-up length was 52.1 months. Eight patients developed a monocyclic systemic form, 8 a polycyclic systemic form and 1 a chronic articular form. Arthralgia (87%) and arthritis (53%) were less frequent than in other series. Sixteen patients were treated: 14 by corticosteroids, 6 by non-steroid anti-inflammatory drugs, 5 by methotrexate, 2 intravenous polyglobulin and one by anti-TNF drug. Patients with a corticodependant or corticoresistant form had more polyarthritis at the onset of the disease (3/6 vs 0/11, P=0.029). DISCUSSION: In internal medicine activity, AOSD without oligo- or polyarthritis may be more frequent than expected according to the literature. Corticotherapy alone is often efficient in these AOSD form without synovitis, and methotrexate use is uncommon.
Subject(s)
Still's Disease, Adult-Onset , Adolescent , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antirheumatic Agents/administration & dosage , Antirheumatic Agents/therapeutic use , Aspirin/administration & dosage , Aspirin/therapeutic use , Cohort Studies , Data Interpretation, Statistical , Female , Follow-Up Studies , Humans , Male , Methotrexate/administration & dosage , Methotrexate/therapeutic use , Middle Aged , Prognosis , Prospective Studies , Retrospective Studies , Still's Disease, Adult-Onset/diagnosis , Still's Disease, Adult-Onset/drug therapy , Time Factors , Treatment OutcomeSubject(s)
Abscess/complications , Escherichia coli Infections/complications , Goiter, Nodular/complications , Thyroid Diseases/complications , Abscess/diagnosis , Abscess/therapy , Aged , Anti-Bacterial Agents/therapeutic use , Escherichia coli/isolation & purification , Escherichia coli Infections/diagnosis , Escherichia coli Infections/therapy , Goiter, Nodular/diagnosis , Goiter, Nodular/therapy , Humans , Male , Thyroid Diseases/diagnosis , Thyroid Diseases/therapy , Thyroidectomy , Treatment OutcomeSubject(s)
Histiocytosis, Langerhans-Cell , Biopsy , Diabetes Mellitus, Type 1/complications , Hemochromatosis/complications , Histiocytosis, Langerhans-Cell/diagnosis , Histiocytosis, Langerhans-Cell/diagnostic imaging , Histiocytosis, Langerhans-Cell/pathology , Humans , Lung/pathology , Male , Middle Aged , Radiography, Thoracic , Tomography, X-Ray ComputedSubject(s)
Hernia, Hiatal/diagnosis , Pneumothorax/diagnosis , Aged , Bronchodilator Agents/therapeutic use , Diagnosis, Differential , Diagnostic Errors , Female , Hernia, Hiatal/pathology , Humans , Ipratropium/therapeutic use , Pneumothorax/pathology , Pressure , Respiratory Insufficiency/etiologyABSTRACT
INTRODUCTION: Stauffer's syndrome is a non-metastatic anicteric cholestasis and an inflammatory syndrome usually associated with renal cell carcinoma. EXEGESIS: We present a case report of an eighty-four-year-old woman who had a leiomyosarcoma revealed by Stauffer's syndrome, which disappeared after surgery. CONCLUSION: Abnormal secretion of interleukin-6 by the leiomyosarcoma could explain this syndrome. The association of Stauffer's syndrome and leiomyosarcoma has never been described.
