Poursac Nicolas, Odriozola Itsaso, Truchetet Marie-Elise
Department of Rheumatology, FHU ACRONIM, University Hospital of Bordeaux, 33000 Bordeaux, France.
Immunology Laboratory, ImmunoConcept, UMR CNRS 5164, University Hospital of Bordeaux, 33000 Bordeaux, France.
J Clin Med. 2022 Apr 16;11(8):2232. doi: 10.3390/jcm11082232.
Adult-onset Still's disease is a complex autoinflammatory disease with a multifactorial etiology. Its presentation is less stereotypical than that of a monogenic autoinflammatory disease and is actually relatively common with few specific signs. To avoid under- or over-prescription of complementary examinations, it is useful to advance in a structured manner, taking into consideration the actual added value of each supplemental examination. In this review, we detail the different complementary tests used in adult Still's disease. We consider them from three different angles: positive diagnostic approach, the differential diagnosis, and the screening for complications of the disease. After discussing the various tests at our disposal, we look at the classical diagnostic strategy in order to propose a structured algorithm that can be used in clinical practice. We conclude with the prospects of new complementary examinations, which could in the future modify the management of patients.
成人斯蒂尔病是一种病因多因素的复杂自身炎症性疾病。其临床表现不像单基因自身炎症性疾病那样刻板，实际上相对常见，且特异性体征较少。为避免辅助检查的开具不足或过度，以结构化的方式推进很有用，要考虑到每项补充检查的实际附加价值。在本综述中，我们详细介绍了成人斯蒂尔病中使用的不同辅助检查。我们从三个不同角度来考虑它们：阳性诊断方法、鉴别诊断以及疾病并发症的筛查。在讨论了我们可用的各种检查后，我们审视经典诊断策略，以提出一种可用于临床实践的结构化算法。我们最后展望新的辅助检查，其未来可能会改变患者的管理方式。
