Adult-onset Still's disease

Area of Science:

• Rheumatology
• Infectious Diseases
• Internal Medicine

Background:

• Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder.
• Its clinical presentation can mimic other conditions, making diagnosis challenging.
• The etiology of AOSD remains largely unknown, with potential infectious triggers being investigated.

Purpose of the Study:

• To describe the clinical and laboratory features of four adult patients with AOSD.
• To investigate potential infectious agents, specifically rubella virus, in the pathogenesis of AOSD.
• To evaluate the response to different therapeutic interventions.

Main Methods:

• Case series describing four adult patients.
• Clinical examination, laboratory tests (including synovial fluid analysis), and serological testing for rubella antibodies.
• Detection of rubella virus in urine samples.

Main Results:

• All four patients presented with fever, erythematous maculopapular rash, splenomegaly, and asymmetric oligoarthritis.
• One patient developed erosive arthritis.
• Rubella virus and high rubella antibody titers were detected in one patient.
• Anemia, leukocytosis, and synovial fluid leukocytosis were common laboratory findings.
• Prednisone was required for three patients, with two continuing long-term therapy.

Conclusions:

• Adult-onset Still's disease can present with a distinct set of symptoms including fever, rash, and arthritis.
• A potential association between rubella virus infection and AOSD is suggested by these findings.
• Management often requires corticosteroids, indicating a significant inflammatory component.