Department of Infectious Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Road, Shanghai, China.
Clin Rheumatol. 2012 Jan;31(1):175-81. doi: 10.1007/s10067-011-1798-y. Epub 2011 Jul 20.
Adult-onset Still's disease (AOSD), as a category of connective tissue diseases, has about 5∼9% of fever of unknown origin (FUO) cases. Diagnosis of AOSD was challenging because of its nonspecific characteristics. The present study analyzed clinical manifestations and laboratory findings in a series of patients with AOSD from eastern China. Medical records of 61 patients admitted with FUO and with a discharge diagnosis of AOSD were retrospectively evaluated and analyzed with special focus on clinical manifestations and laboratory findings. Compared with previous reports, most features of our patients had a similar incidence rate. Rash (79%), arthralgia (80%), and sore throat (84%) were the most frequent clinical manifestations in our series. Leukocytosis (80%), elevated ESR (98%) and CRP (100%), negative ANA (90%) and RF (93%), and high ferritin level (94%) were the most sensitive laboratory findings in our patients. AOSD was not a rare reason of FUO in eastern China. Fever, arthralgia, rash, sore throat, leukocytosis, neutrophilia, elevated ESR and CRP, negative ANA and RF, and high ferritin level were the most common clinical features in our series. The lack of highly specific characteristic makes the diagnosis of AOSD difficult compared with other diseases in FUO.
成人Still 病（AOSD）作为一种结缔组织疾病，约占不明原因发热（FUO）病例的 5∼9%。由于其非特异性特征，AOSD 的诊断具有挑战性。本研究分析了来自中国东部的一系列 AOSD 患者的临床表现和实验室检查结果。回顾性评估和分析了 61 例以 FUO 入院且出院诊断为 AOSD 的患者的病历，特别关注临床表现和实验室检查结果。与以往的报告相比，我们患者的大多数特征具有相似的发病率。皮疹（79%）、关节炎（80%）和咽痛（84%）是我们系列中最常见的临床表现。白细胞增多（80%）、血沉升高（98%）和 C 反应蛋白升高（100%）、抗核抗体阴性（90%）和类风湿因子阴性（93%）以及铁蛋白水平升高（94%）是我们患者最敏感的实验室发现。AOSD 在中国东部并不是 FUO 的罕见原因。发热、关节炎、皮疹、咽痛、白细胞增多、中性粒细胞增多、血沉和 C 反应蛋白升高、抗核抗体和类风湿因子阴性以及铁蛋白水平升高是我们系列中最常见的临床特征。与 FUO 中的其他疾病相比，缺乏高度特异性特征使得 AOSD 的诊断变得困难。
