Clinical characteristics, treatment, and outcome of adult onset Still's disease in southern Chinese

Objective. To study the clinical characteristics, treatment outcome, and co mplications of patients with adult onset Still's disease (AOSD) in our loca l Chinese population. Methods, Patients with AOSD were identified among others who attended our r heumatology clinics from 1967 to 1997 and were followed. Their clinical and laboratory features at presentation, treatment, and outcome were recorded and compared with other reported series. Results, Sixteen patients with AOSD were identified. Eleven (69%) were fema le. Nine (56%) had onset of the disease between 16 and 35 years of age. The commonest presenting features were fever (100%), arthritis (94%), rash (85 %), weight loss (69%), and sore throat (63%). Fifteen patients presented wi th pyrexia of unknown origin and the median duration of fever before the es tablishment of the diagnosis was 6 weeks (range 4-75), The acute phase resp onse was marked in all patients with gross elevation of erythrocyte sedimen tation rate (ESR), C-reactive protein (CRP), and complement levels. Hyperfe rritinemia (> 5 times normal) was present in 90% of cases. Most patients (8 1%) required corticosteroid therapy and 85% of those steroid treated patien ts received additional disease modifying agents. The mean duration of follo wup of our patients was 93.3 months (range 8-362). Five (33%) had monocycli c systemic disease, 6 (40%) had polycyclic systemic disease, and 4 (27%) ha d frequent relapses that progressed to a chronic arthropathy. Conclusion. AOSD in southern Chinese tends to run a benign course, with few patients evolving into chronic inflammatory arthropathy. A significantly l ower incidence of serositis, lung involve ment, and enlargement of the reti culoendothelial organs was observed at presentation compared with patients of different ethnic origins.