Thirty-seven cases of adult-onset Still's disease:a retrospective analysis

MA Lijuan; YAN Qiuhong; YUAN Xiaoying

doi:10.3969/j.issn.2097-1753.2025.04.017

Abstract：Objective To analyze the clinical characteristics of adult onset Still's disease(AOSD)in order to improve the diagnostic accuracy and therapeutic effect and reduce the incidence.Methods The clinical data of 37 inpatients with adult-onset Still's disease admitted to Air Force Medical Center in 2021-2024 was collected and analyzed retrospectively.Results Thirty-four patients received blood cultures while another 30 patients underwent bone marrow puncture to rule out the possibility of infections or tumors.There was fever in 35 cases,rash in 31 cases,arthralgia in 28 cases,muscle pain in 25 cases,pharyngeal pain in 19 cases,itching in 19 cases,swollen lymph nodes in 15 cases and an enlarged spleen in 1 case.According to laboratory indicators,there were 25 cases whose white blood cells exceeded10×109/L,23 cases of liver dysfunction,33 cases of negative rheumatoid factors,and 32 cases of negative antinuclear antibodies.Two cases were not treated symptomatically.Only NSADs were used in 3 cases.while compound glycyrrhizin injection alone was used in 5 cases.Glucocorticoids were used in 27 cases,immunosuppressors combined with glucocorticoids in 4 cases,and IVIG in 2 cases.Two cases were complicated with macrophage activation syndrome,who were treated with high-dose glucocorticoids and IVIG.Conclusion The main manifestations of AOSD are fever,rash,joint pain,muscle pain,sore throat and itching.Specific laboratory indicators for diagnosis of AOSD are still lacking.Glucocorticoids are the first-line treatment of AOSD.In severe cases,immunosuppressants and IVIG can be added for treatment.