Still's disease: part I. Manifestations and complications in sixty-five cases in
Masson C Le Loet X
Liote F Renou P
OBJECTIVES: (1) To compare clinical and laboratory findings in our patients with those reported in earlier studies, particularly two large series from Canada and Japan, respectively; (2) to describe the systemic and visceral complications associated with adult Still's disease.
RESULTS: as compared with the
two above- mentioned series, our study group included more patients who had
experienced onset of their disease after the age of 35 years and fewer
patients with involvement of the liver, spleen, or lymph nodes. Rates of
occurrence of arthritis, myalgia, sore throat, pleuritis, pericarditis,
and abdominal pain were significantly higher in the Canadian series than
in the other two series. Arthritis was absent in one fourth of our
patients. Life-threatening complications included
OBJECTIVES: were as follows: 1) to describe treatments used; 2) to analyze disease course patterns; 3) to study joint alterations; 4) to determine whether any characteristics present within the first six months of onset were of prognostic significance.
RESULTS: aspirin was ineffective. Indomethacin ensured satisfactory control in eight patients. Corticosteroid therapy was required in 88% of cases. Among patients followed up for more than one year, half developed radiologic joint alterations; 23% had monocyclic systemic disease, 38.5% had polycyclic systemic disease and 38.5% had chronic articular disease. More than half of the patients (58%) had more than one systemic flare. Polyarthritis at onset and involvement of the proximal limb joints were significantly predictive of chronic articular disease, whereas isolated arthralgia was predictive of monocyclic or polycyclic systemic disease. Oligoarthritis was not predictive of the outcome.
CONCLUSION: the knowledge that
polyarthritis or proximal limb joint involvement within six months of
onset is predictive of chronic joint disease may have important therapeutic
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