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Enfermedad de Still del adulto: Una gran simuladora. Experiencia clínica basada en 20 casos

    1. [1] Hospital San Juan de Dios

      Hospital San Juan de Dios

      Santiago, Chile

    2. [2] Hospital San Borja Arriarán Unidad de Reumatología Servicio de Medicina
  • Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 137, Nº. 8, 2009, págs. 1010-1016
  • Idioma: español
  • Títulos paralelos:
    • Adult Still's disease: Retrospective review of 20 patients
  • Enlaces
  • Resumen
    • 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 ¡eukocytosis 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 ¡eflunomide 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.

Los metadatos del artículo han sido obtenidos de SciELO Chile

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