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[Hepatic manifestations in Still's disease]
J P Algayres1, J P Daly, B Oddes
1Clinique Médicale, Hôpital d'Instruction des Armées du Valde-Grâce, Paris.
Annales De Medecine Interne
|January 1, 1988
Summary
Still's disease in children and adults involves fever, rash, and joint pain. Hepatic manifestations, including cytolysis and rare life-threatening jaundice, can be unmasked or worsened by salicylate therapy.
Area of Science:
- Pediatric Rheumatology
- Hepatology
- Internal Medicine
Background:
- Still's disease, a systemic inflammatory condition, typically presents with fever, rash, and arthritis in both children and adults.
- While visceral involvement is common, hepatic manifestations require specific attention.
- Understanding the spectrum of liver involvement is crucial for managing this condition.
Observation:
- Two cases of Still's disease highlight hepatic manifestations.
- Common biochemical abnormalities include mild cytolysis.
- Jaundice is less frequent but can indicate severe polyvisceral disease and disseminated intravascular coagulation.
Findings:
- Hepatic involvement in Still's disease can range from mild biochemical changes to life-threatening conditions.
- Salicylate therapy, while a common treatment, may exacerbate underlying hepatic abnormalities.
- The anatomical changes observed are consistent regardless of whether manifestations are spontaneous or secondary to salicylate treatment.
Implications:
- Clinicians should monitor liver function in patients with Still's disease, particularly those on salicylate therapy.
- Early recognition of hepatic involvement is critical for preventing severe complications.
- Further research into the interaction between salicylate therapy and hepatic abnormalities in Still's disease is warranted.