Barrientos-Flores Corazón Jesús, Noyola-García Maura E, Albarrán-Sánchez Alejandra, Torres-Araujo Laura Victoria, Cano-Ortega Yisela, Alberti-Minutti Paolo, Anda-Garay Juan Carlos
Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades, Servicio de Medicina Interna, Ciudad de México, México.
Rev Alerg Mex. 2020 Oct-Dec;67(4):413-420. doi: 10.29262/ram.v67i4.811.
In Mexico, adult-onset Still's disease (AOSD) is one of the causes of fever of unknown origin (FUO). The aim of this study is to describe a series of AOSD cases from a FUO cohort in order to know the clinical and biochemical characteristics of the cases, as well as to describe the neutrophil-lymphocyte index (NLI), which is a clinical marker of inflammation in autoimmune diseases.
An observational study of 24 cases with AOSD; 72 % of them were women, the median age was 43 years (IQR 37.7-59.7), and the most frequent manifestations were classic rash (84 %) and arthralgia (100 %). All of them had tested negative for rheumatoid factor, antinuclear antibodies, and hyperferritinemia; 83 % had NLI > 3.08. The most used treatment was the combination of methotrexate with corticosteroids; seven patients required biological therapy, and one of them presented a hypersensitivity reaction.
When there's FUO, the existence of AOSD should be suspected; also in the presence of rash, arthralgia, hyperferritinemia, and NLI > 3.08.
在墨西哥，成人斯蒂尔病（AOSD）是不明原因发热（FUO）的病因之一。本研究的目的是描述一组来自FUO队列的AOSD病例，以了解这些病例的临床和生化特征，并描述中性粒细胞与淋巴细胞比值（NLI），其是自身免疫性疾病炎症的临床标志物。
一项对24例AOSD病例的观察性研究；其中72%为女性，中位年龄为43岁（四分位间距37.7 - 59.7），最常见的表现为典型皮疹（84%）和关节痛（100%）。所有患者类风湿因子、抗核抗体检测均为阴性，且无高铁蛋白血症；83%的患者NLI > 3.08。最常用的治疗方法是甲氨蝶呤与皮质类固醇联合使用；7例患者需要生物治疗，其中1例出现过敏反应。
当出现FUO时，应怀疑AOSD的存在；在出现皮疹、关节痛、高铁蛋白血症且NLI > 3.08时也应怀疑。
