[Adult-onset Still's disease]

Area of Science:

• Rheumatology
• Internal Medicine

Context:

• Adult-onset Still disease (AOSD) presents diagnostic challenges.
• Lack of specific clinical or laboratory anomalies complicates AOSD diagnosis.
• Diagnosis relies on excluding other conditions, demanding judicious use of tests.

Purpose:

• To outline the diagnostic difficulties of Adult-onset Still disease.
• To discuss pragmatic treatment strategies for AOSD.
• To define the role of biologic therapies in AOSD management.

Summary:

• Adult-onset Still disease diagnosis is complex, often requiring exclusion of other diseases.
• Diagnostic challenges stem from the absence of specific clinical or laboratory findings.
• Treatment approaches are pragmatic, tailored to individual patient circumstances and objectives.
• Biologic treatments are effective but should be reserved for refractory or corticodependent cases.

Impact:

• Improved understanding of AOSD diagnostic criteria.
• Guidance on rational exclusion testing for AOSD.
• Framework for pragmatic and objective-driven AOSD treatment.
• Clarification on the appropriate use of advanced therapies in AOSD.