Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos
| Autor: | Francisco Ballestero, Aurelio Carvallo V, M Ángela Carreño, Carola Martínez, Cecilia Trejo |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Pediatrics Fever of unknown origin Adult Still's disease medicine.diagnostic_test business.industry adult onset Hydroxychloroquine Retrospective cohort study General Medicine medicine.disease Rash non-steroidal Surgery Erythrocyte sedimentation rate Still's disease Antiinflammatory agents medicine Leukocytosis medicine.symptom business Odynophagia medicine.drug |
| Zdroj: | Revista médica de Chile v.137 n.8 2009 SciELO Chile CONICYT Chile instacron:CONICYT |
| ISSN: | 0034-9887 |
| DOI: | 10.4067/s0034-98872009000800002 |
| Popis: | 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 leukocytosis 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 leflunomide 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 (Rev Med Chile 2009; 137: 1010-6). |
| Databáze: | OpenAIRE |
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