The Journal of the Korean Rheumatism Association  1995;2(1):52-59

Clinical Analysis Of Adult Onset Still's Disease: 22 Cases In Korea.

Eun Bong LEE 1 ; Yeong Wook SONG

Affiliations

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Keywords

Adult Inset Still's Disease; Fever; Skin rash; Arthritis; Leukocytosis

Country

Republic of Korea

Language

Korean

MeSH

Abstract

OBJECTIVE: To investigate the clinical manifestations of adult onset Still's disease in Korea. METHODS: 22 patients who were diagnosed at Seoul National University Hospital during 10 years from March, 1984 to June, 1994 were reviewed. RESULTS: Age of onset was evenly distributed between 16 and 45 years in most of the patients. Fever and arthralgia were present in all cases. Arthritis and skin rash were developed in 91% and 77% of the patients respectively. Laboratory tests showed accelerated ESR in 95~o, increased serum ferritin in 79%, leukocytosis in 68%, anemia in 32%, hypoalbuminemia in 32%, and abnormal liver function test in 36% of the patients. Commonly affected joints were knees, wrists, proximal interphalangeal joints, ankles, elbows and shoulders in order. Bone marrow biopsy in 7, lymph node biopy in 2 cases revealed reactive hyperplasia. Nonsteroidal anti-inflammatory drugs (NSAID) were effective in 73% of the patients, corticosteroid with or without NSAID in 50% of the patients. Toxic hepatitis was developed in 2, acute renal failure in 1 and drug rash in 1 case during NSAID treatment, which resolved after discontinuance or switching to another NSAID. CONCLUSIONS: The clinical manifestations of AOSD in Korea generally resemble those previously reported in other countries except that lymphadenopathy, splenomegaly, joint deformity, pleurisy, leukocytosis and anemia were significantly less frequent in our cases.