disease; clinical and laboratory features, treatment
In only 43 per cent of these did the disease present with the classical triad of fever, arthritis and rash, although in the whole group eventually, fever with temperatures of 40 degrees C or more occurred in 84 per cent, arthritis in 98 per cent, and the typical rash in 82 per cent. In 32 per cent of the patients with rash, this was pruritic.
Other features seen
frequently were: lymphadenopathy (71 per cent), splenomegaly (36 per cent),
pleuritis and/or pneumonitis (31 per cent), pericarditis (22 per cent),
leucocytosis (98 per cent) and hepatic abnormalities (84 per cent). The high
spiking fever was reduced to normal in six of 21 cases (29 per cent) by aspirin,
in 19 of 27 cases
Eight patients whose joint disease improved on steroids later developed severe joint destructions. Thirteen patients received one or several slow-acting antirheumatic drugs. Only in eight of 18 trials (44 per cent) with one of these drugs did symptoms and signs improve. Fifty-one percent of the 45 patients had self-limiting disease and 49 per cent had persistent disease with continuous activity for at least one year.
Disability was determined
primarily by the course of the arthritis. At the time of review 43 per cent of
the 45 patients had no joint
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