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ADULT-ONSET STILL'S DISEASE

Rheumatology

ADULT-ONSET STILL'S DISEASE

1. Occurs primarily in adults in their 20s to 30s; onset after age 60 is unusual.

2. P/W a distinctive "evanescent" (means "vanishing" or "disappearing"), macular, salmon-pink rash that coincides with a daily ("quotidian") high, spiking fever and significant leukocytosis (Yamaguchi criteria).

3. Mild oligoarthritis usually develops, some may progress to a destructive polyarthritis with fusion (especially the wrists).

4. High serum ferritin level (> 10x normal) is strongly associated with this disease and correlates with severe disease activity.

5. Treat with NSAIDs, steroids and DMARDs (Methotrexate).


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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