[Clinical study of Still's disease as a distinct disease entity]

There seems to be yet unresolved questions as to whether child-onset and adult-onset Still's disease are truly the same disease and whether adult-onset Still's disease is a disease entity independent of other rheumatic diseases in the adult. In order to clarify these issues, we have analyzed statistically the clinical features of Still's disease of various age-onset and also compared the features of adult-onset Still's disease with those of other rheumatic diseases having similar manifestations. Clinical data used for the study were those collected from 32 institutions in Japan through questionnaire method by Adult Still's Disease Research Committee, and the patients with adult Still's disease and with other rheumatic diseases were definitely diagnosed by the Committee. When the sensitivity of each of total 90 clinical items was compared between child-onset adult Still's disease (11 cases) and adult-onset Still's disease (77 cases), and between young adult-onset (16-35 years) Still's disease (48 cases) and aged adult-onset (45 years or older) Still's disease (15 cases), only 7-9% of the items showed significant difference by chi 2-test. This was the same range as when the sensitivity of the clinical items obtained from the literature of child-onset Still's disease (26 cases) was compared with that of adult-onset Still's disease (77 cases). On contrary to this range, over half of the items showed the significant difference in sensitivity when adult-onset Still's disease was compared with other rheumatic diseases such as seronegative rheumatoid arthritis (31 cases), malignant rheumatoid arthritis (25 cases), and polyarteritis nodosa (31 cases).(ABSTRACT TRUNCATED AT 250 WORDS)