Murden R A
University of Kansas Medical Center, Kansas City.
J Gen Intern Med. 1992 May-Jun;7(3):366-8. doi: 10.1007/BF02598097.
A case is presented of a 32-year-old man with classic clinical adult-onset Still's disease, who had an initially elevated (1:320) but not persistently high rheumatoid factor. Since lack of a high rheumatoid factor is one feature in the proposed classification criteria for adult-onset Still's disease, the patient was given a diagnosis of rheumatoid arthritis. The faulty reasoning behind this diagnosis of rheumatoid arthritis is discussed, focusing on the inappropriate use of classification criteria for individual clinical diagnosis, as well as the occasional need for longitudinal diagnosis.
本文报告了一例32岁患有典型成人起病型斯蒂尔病的男性患者，其类风湿因子最初升高（1:320），但并非持续高水平。由于类风湿因子不高是成人起病型斯蒂尔病拟议分类标准中的一个特征，该患者被诊断为类风湿关节炎。本文讨论了类风湿关节炎这一诊断背后的错误推理，重点在于分类标准在个体临床诊断中的不当应用，以及纵向诊断的必要性。
