DOES MONOCYCLIC STILLS-DISEASE EXIST - CO NSIDERATIONS WITH REFERENCETO 3 CASES

Adult-onset Still's disease is characterized by a fairly uniform patte rn of clinical manifestations and laboratory test abnormalities. Howev er, the diagnosis can be difficult since no signs are specific, a situ ation that has prompted the development of diagnostic criteria. In add ition, the etiopathogenesis of the disease is unknown and the course v aries widely, resulting in nosologic uncertainties. Acute forms with a single flare followed by a full recovery, called monocyclic forms, ra ise the issue of whether adult-onset Still's disease may be related to infectious organisms; several pathogens have been incriminated in sim ilar clinical patterns. Inclusion of an outcome criterion in the defin ition of adult-onset Still's disease may avoid overdiagnosis of the co ndition by excluding potentially infection-related conditions. This wo uld help increase the homogeneity of the disease.