Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003862 (arthralgia)
 7,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The article describes two cases of adult Still's disease and reviews the relevant literature. Adult onset Still's disease is characterized by high peaks of fever, arthritis, arthralgia, rash, increased erythrocyte sedimentation rate, leucocytosis, liver dysfunction and negative tests for antinuclear antibodies and rheumatoid factors. Still's disease should be regarded as a possible differential diagnosis in adult patients who present such features.
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PMID:[Adult-onset Still's disease. Diagnosis, differential diagnosis and treatment]. 157 36

Adult onset Still's disease is a variant of systemic juvenile chronic arthritis in adulthood. The clinical picture is characterized by high spiking fever, arthralgia/arthritis, transient erythema, acute-phase reaction including elevated ESR, CRP and neutrophilia, resembling acute bacterial infections. Hyperferritinaemia and hepatic dysfunction are usually present, and the patients frequently have a sore throat. Extraarticular features, such as splenomegalia, serositis and pericarditis may be parts of this disease as well. Two cases are described, who were admitted to the Department of Internal Medicine of a small Norwegian hospital. Both patients were subjected to exhaustive and laborious investigations for the purpose of disclosing malignancy and/or septicaemia. Following adequate glucocorticoid therapy, both were asymptomatic after less than a week's treatment and after five months' follow-up. Two sets of diagnostic criteria are presented, having different sensitivity, although almost equal specificity. Still's disease in the adult may be an underdiagnosed clinical entity, but should definitely be considered to be a possible differential diagnosis when investigating suspected malignancy, including lymphoma and febrile conditions suspected of septicaemia.
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PMID:[Adult-onset Still's disease. An underdiagnosed condition?]. 853 15

A 44-year-old woman was admitted to our hospital because of a high fever that had continued for three weeks. She complained of a sore throat and arthralgia, and had a salmon-pink rash, lymphadenopathy, liver dys-function, and hyperferritinemia. Tests for RF and ANA were negative. Adult-onset Still's disease was diagnosed. Despite administration of steroids, pericarditis, interstitial pneumonitis, and disseminated interavascular coagulation developed. After cyclophosphamide was given, the patient's condition improved, but reticular shadows and volume loss remained on the chest X-ray film. A chest CT scan showed ground-glass-like opacities and linear shadows, and irregular bronchovascular bundles. Bronchoalveolar lavage and transbronchial lung biopsy were done. Alveolar macrophages accounted for 71% of the cells in the bronchoalveolar lavage fluid, and lymphocytes (CD 4/ CD 8 ratio = 1.01) accounted for 29%. Examination of a specimen obtained by transbronchial lung biopsy showed thickened alveolar walls and infiltration of lymphocytes. Reports of cases of adult-onset Stills disease that include results of bronchoalveolar lavage and transbronchial lung biopsy are rare.
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PMID:[Interstitial pneumonitis detected by bronchoalveolar lavage and transbronchial lung biopsy in adult-onset Still's disease]. 975 7

In three patients, two women aged 70 and 19 years and a man aged 33 years with long-lasting fever no diagnosis was made after extensive diagnostic work-up. After exclusion of infectious, malignant and rheumatic diseases, adult-onset Still's disease was diagnosed in all three patients on the basis of clinical and laboratory criteria. Adult-onset Still's disease is an important but less well known cause of fever. Clinically, adult-onset Still's disease is characterized by the triad of fever, skin rash and arthritis/arthralgia. A greatly elevated serum ferritin level proved to be an additional valuable diagnostic clue. Treatment consists of non-steroidal anti-inflammatory drugs, corticosteroids or immunosuppressive agents. The long-term prognosis is usually good, but severe joint destruction may occur. All three patients recovered.
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PMID:[Fever of unknown origin caused by the adult form of Still's disease]. 1092 51

Adult-onset Still's disease (AOSD) is a rare disorder of unknown aetiology, characterised by high spiking fever, an evanescent, erythematous, maculopapular rash, arthralgia or arthritis, lymphadenopathy, hepatosplenomegaly, sore throat and serositis. It is associated with marked leukocytosis, high erythrocyte sedimentation rate, increased level of serum ferritin and negative rheumatoid factor and antinuclear antibody tests. Here we report a patient in whom an urticaria-like rash was an uncommon presenting clinical feature of AOSD. To our knowledge, this association has only been reported once before.
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PMID:Urticaria as a presenting manifestation of adult-onset Still's disease. 1105 30

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology characterized by an evanescent rash, intermittent spiking high fever, arthralgia, and a variety of systemic features. We describe a 46-yr-old woman with Still s disease who presented with a 2-month history of a symmetrical vesiculopustular eruptions only on both hands and feet. Skin biopsy specimens of both vesicle and pustule revealed fibrin thrombi deposition in the small dermal vessels with little inflammation, subepidermal bulla, and ischemic necrosis of the overlying epidermis, which were consistent with a vasculopathic reaction. Her skin lesions gradually disappeared in response to conventional AOSD therapy, as elevated serum ferritin levels, an index of disease activity, decreased. To the best of our knowledge, this is the first case of vesiculopustular lesions as a skin manifestation of AOSD.
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PMID:Adult-onset Still's disease with vesiculopustules on the hands and feet. 1248 16

A 24-year-old woman was admitted to our hospital because of a high fever that had persisted for two weeks. She complained of a sore throat and arthralgia, and had evanescent rash, lymphadenopathy, liver dysfunction, and hyperferritinemia. Tests for RF and ANA were negative. Adult-onset Still's disease was diagnosed. On the fifth day of hospitalization, acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC) developed. Treatment consisted of mechanical ventilation and administration of steroid pulse-therapy and gabexate mesilate. Analysis of fluid obtained by bronchoalveolar lavage showed increases in the total cell count, predominantly of neutrophils and lymphocytes. Bilateral pulmonary infiltration seen on chest radiographs was alleviated, and the arterial blood gas data gradually improved. After cyclosporine was given, all the above symptoms associated with adult-onset Still's disease disappeared. Plasma levels of inflammatory cytokines decreased with the improvement of the patient's clinical condition.
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PMID:[A case of adult-onset Still's disease complicated with acute respiratory distress syndrome]. 1264 11

Adult onset Still's disease is a rare systemic disorder of unknown etiology occuring in young adults. The diagnosis is difficult and based upon Yamaguchi's criteria after exclusion of infectious diseases, hemotologic process or autoimmune diseases. Clinical manifestations are various. Functional prognosis depends essentially on articular involvement. We report a retrospective and multicenter study of 26 cases of adult still's disease collected during 10 years. Arthralgia are constant and arthritis are observed in third of the cases. Radiologic joint alterations are found in five cases. A literature review was done with emphasis on clinical and radiological characteristics of articular manifestations.
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PMID:[Articular manifestations of adult Still's disease]. 1284 7

Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology and pathogenesis. AOSD is a rare condition, usually presenting with high fever accompanied by systemic manifestations. The disease is a heterogeneous pathological entity with a range of etiologies, manifestations and prognosis. There is no single diagnostic test for AOSD; rather, the diagnosis is based upon clinical criteria such as arthralgia, fever, skin rash, lymphadenopathy, and hepatosplenomegaly. Determination of the procalcitonin level and the biological response to empirical corticosteroid therapy generally helps the diagnosis, while immune-serology, as a 'screening' test, will not add meaningful information in most cases. Treatment consists of anti-inflammatory medications. Non-steroid anti-inflammatory drugs have limited efficacy, corticosteroid therapy and disease-modifying antirheumatic drugs are usually required. Novel therapeutic approaches, such as anti-tumor necrosis factor blockade and stem cell transplantation, are promising. In this chapter we present clinical and laboratory parameters of 18 patients diagnosed with AOSD at our institution between 1997 and 2003, and review the literature.
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PMID:Adult-onset Still's disease. 1545 25

Adult onset Still's disease (AOSD) is an uncommon acute systemic inflammatory disease of unknown origin. The clinical features include high spiking fever, arthralgia or arthritis, transient maculopapular rash, lymphadenopathy, hepatosplenomegaly, and serositis. Pericarditis is the most common cardiac manifestation of AOSD and occurs in approximately 30% of cases. A simultaneous occurrence of rapidly progressive bi-valvular regurgitation associated with AOSD has not been previously described. We report a case of a 55-year old woman who underwent mitral valve replacement and Bentall's operation due to acute severe mitral and aortic regurgitation associated with AOSD.
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PMID:Adult onset Still's disease as a cause of acute severe mitral and aortic regurgitation. 1629 89


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