Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos

Background: Adult Still's disease is an inflammatory disorder characterized by quotidian fevers, and an evanescent rash. Its presentation can be acute or subacute. Aim: To report our experience with Adult Still's disease. Material and methods: Systematic retrospective review of medical rec...

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Autores principales:	Carreño,M Ángela, Carvallo,Aurelio, Trejo,Cecilia, Ballestero,Francisco, Martínez,Carola
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2009
Materias:	Antiinflammatory agents non-steroidal Fever of unknown origin Still's disease adult onset
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009000800002
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spelling	oai:scielo:S0034-988720090008000022009-11-04Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casosCarreño,M ÁngelaCarvallo,AurelioTrejo,CeciliaBallestero,FranciscoMartínez,Carola Antiinflammatory agents non-steroidal Fever of unknown origin Still's disease adult onset Background: Adult Still's disease is an inflammatory disorder characterized by quotidian fevers, and an evanescent rash. Its presentation can be acute or subacute. Aim: To report our experience with Adult Still's disease. Material and methods: Systematic retrospective review of medical records of nine men and 11 women aged between 17 and 57 years, with Still's disease, followed in two public hospitals of Metropolitan Santiago. Results: Eighty percent of patients had a prior different diagnosis. All presented with fever and joint involvement. Eighty percent had malaise, 80% had odynophagia, 80% had an evanescent rash, 70% had myalgias, 50% had lymph node enlargement and 40% had splenomegaly. Laboratory showed ¡eukocytosis in 80% and a high erythrocyte sedimentation rate in all. High ferritin levels were detected in 80%, and became an important diagnosis clue. Initial treatment was based on non steroidal antiinflammatory drugs, however 80% required steroids and 35% required methotrexate. Azathioprine, sulphalazine, hydroxychloroquine and ¡eflunomide were used occasionally. Eleven patients had a single episode, nine had a relapsing disease and four had a chronic or persistent mode. Conclusions: Adult Still's disease must be suspected in patients with fever of unknown origin. An early diagnosis and adequate treatment of the disease are associated with a favorable evolution and prognosis.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.137 n.8 20092009-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009000800002es10.4067/S0034-98872009000800002
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Antiinflammatory agents non-steroidal Fever of unknown origin Still's disease adult onset
spellingShingle	Antiinflammatory agents non-steroidal Fever of unknown origin Still's disease adult onset Carreño,M Ángela Carvallo,Aurelio Trejo,Cecilia Ballestero,Francisco Martínez,Carola Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos
description	Background: Adult Still's disease is an inflammatory disorder characterized by quotidian fevers, and an evanescent rash. Its presentation can be acute or subacute. Aim: To report our experience with Adult Still's disease. Material and methods: Systematic retrospective review of medical records of nine men and 11 women aged between 17 and 57 years, with Still's disease, followed in two public hospitals of Metropolitan Santiago. Results: Eighty percent of patients had a prior different diagnosis. All presented with fever and joint involvement. Eighty percent had malaise, 80% had odynophagia, 80% had an evanescent rash, 70% had myalgias, 50% had lymph node enlargement and 40% had splenomegaly. Laboratory showed ¡eukocytosis in 80% and a high erythrocyte sedimentation rate in all. High ferritin levels were detected in 80%, and became an important diagnosis clue. Initial treatment was based on non steroidal antiinflammatory drugs, however 80% required steroids and 35% required methotrexate. Azathioprine, sulphalazine, hydroxychloroquine and ¡eflunomide were used occasionally. Eleven patients had a single episode, nine had a relapsing disease and four had a chronic or persistent mode. Conclusions: Adult Still's disease must be suspected in patients with fever of unknown origin. An early diagnosis and adequate treatment of the disease are associated with a favorable evolution and prognosis.
author	Carreño,M Ángela Carvallo,Aurelio Trejo,Cecilia Ballestero,Francisco Martínez,Carola
author_facet	Carreño,M Ángela Carvallo,Aurelio Trejo,Cecilia Ballestero,Francisco Martínez,Carola
author_sort	Carreño,M Ángela
title	Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos
title_short	Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos
title_full	Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos
title_fullStr	Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos
title_full_unstemmed	Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos
title_sort	enfermedad de still del adulto: una gran simuladora. experiencia clínica basada en 20 casos
publisher	Sociedad Médica de Santiago
publishDate	2009
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009000800002
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Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos

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