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Adult-onset Still disease
1Pierre & Marie Curie-Paris VI University/Paris Universitas, Department of Rheumatology, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75651 Paris, Cedex 13, France. bruno.fautrel@psl.aphp.fr
Adult-onset Still disease (AOSD) is a rare inflammatory condition. Diagnosis can be challenging, but ferritin levels may assist, and treatment involves corticosteroids, methotrexate, or biologics like anakinra and tocilizumab.
Area of Science:
- Rheumatology
- Immunology
- Internal Medicine
Background:
- Adult-onset Still disease (AOSD) is an uncommon inflammatory disorder of unknown etiology.
- Characterized by fever, arthritis, rash, and leukocytosis, AOSD diagnosis can be complex due to varied manifestations.
Purpose of the Study:
- To summarize the diagnostic challenges and therapeutic strategies for Adult-onset Still disease.
- To highlight the role of ferritin levels and current treatment options.
Main Methods:
- Review of clinical characteristics, diagnostic aids, and treatment outcomes for AOSD.
- Analysis of disease evolution patterns and therapeutic responses.
Main Results:
- Elevated ferritin levels can aid in AOSD diagnosis, though not definitively.
- Disease courses include monocyclic, polycyclic, and chronic patterns, with joint erosion in one-third of chronic cases.
- Corticosteroids are first-line, methotrexate is effective for steroid-sparing, and biologics (anakinra, tocilizumab) are options for refractory disease.
Conclusions:
- AOSD diagnosis requires careful consideration of cardinal symptoms and supportive markers like ferritin.
- Treatment strategies are guided by disease severity and response, progressing from corticosteroids to advanced therapies.
- Further research is needed to identify prognostic factors and optimize AOSD management.
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