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Type: Artigo de periódico
Title: Adult-onset still disease in southeast Brazil
Author: Appenzeller, S
Castro, GRW
Costallat, LT
Samara, AM
Bertolo, MB
Abstract: Background: Adult-onset Still disease (AOSD) has been described all over the world. Clinical presentations and prognosis have varied in different studies. Objective: The objective of this study was to determine the clinical presentation and the evolution of AOSD at a tertiary referral center in southeast Brazil. Methods: The clinical records of 16 patients were retrospectively studied to determine symptoms at diagnosis, follow up, and the medication prescribed. Results: The mean age at onset was 30.8 years (range, 24-55 years; standard deviation [SD], 9.2 years) with a slight male prevalence (54.2%). All patients presented constitutional symptoms, fever, and skin rash. Liver involvement was observed in all cases, with hepatomegaly in 81.3%, increased liver enzymes in 50.0%, and hypergammaglobulinemia in 68.8%. Cardiac involvement was observed in 12.6%, pleuritis in 6.3%, and renal involvement in 25.0%. All patients presented leukocytosis with a predominance of neutrophils. Elevated ferritin levels were observed in 56.3%, and these levels were normalized after disease remission. Initial treatments included nonsteroidal anti inflammatory drugs and low-dosage corticosteroids in all patients; 43.8% also needed methotrexate. In 25.0% of cases, a monocyclic disease was observed; others had recurrent episodes. After a follow up of 6.9 years (SD, 1.2 years), carpal ankylosis was the main articular sequel, observed in 53.6% of the patients. Conclusion: AOSD is rare in southeast Brazil. Although less severe systemic manifestations, like serositis and pneumonitis, were observed, reversible liver involvement was common; the frequency of recurrent disease and carpal ankylosis was higher than in previous studies.
Subject: adult-onset Still disease
Country: EUA
Editor: Lippincott Williams & Wilkins
Citation: Jcr-journal Of Clinical Rheumatology. Lippincott Williams & Wilkins, v. 11, n. 2, n. 76, n. 80, 2005.
Rights: fechado
Identifier DOI: 10.1097/01.rhu.0000158544.38663.0a
Date Issue: 2005
Appears in Collections:Unicamp - Artigos e Outros Documentos

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