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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In both Still disease and Wissler-Fanconi syndrome, onset may occur in adulthood and the clinical picture includes acute, often migratory, polyarthritis, polymorphic exanthema and a major inflammatory syndrome with fever (often intermittent) and high polymorphonuclear leukocyte counts. The grounds for this double designation are not clearly stated in the medical literature: does it refer to two separate entities or not? Some authors plainly stand for a unitary opinion. We report on seven cases in adults, five of which recovered without sequellae, while two developed respectively into rheumatoid arthritis and seronegative polyarthritis. We therefore propound a dualistic concept although, in the present state of our knowledge, there is no means of predicting at onset whether the disease will resolve or progress towards polyarthritis. We suggest that the term Still disease be used only when chronic and/or destructive arthritis develops. Among the forms which are neither chronic nor destructive, there seems to be a number of cases in allergic patients with poor tolerance of chrysotherapy. Some of these patients could recover after the cure of an often latent focal infection, usually of the upper respiratory tract, ear or oral cavity, resistant to antibiotics. In the other cases, corticosteroid therapy is usually very effective in arresting an exacerbation of the disease.
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PMID:[Wissler-Fanconi syndrome and Still's disease in adults. Nosological and etiological problems and borderline forms. Apropos of 7 cases]. 630 Oct 51

Abstract A 9-year-old boy fell ill with respiratory symptoms and high fever, followed after a day or so by acute pleuritis. A classical Wissler's syndrome developed with altogether 3 attacks of high fever within the course of a month, various forms of exanthema on 2 occasions, arthritis in knee-joint, leucocytosis with eosinophilia attaining an extreme degree, and a high erythrocyte sedimentation rate. Blood cultures were negative; and, through extensive bacteriological tests and serological reactions, infections with various bacteria, mycoplasma, psittacosis agent and ordinary respiratory virus could be excluded with the exception of parainfluenza 2, for which infection there was clear serological evidence. Urinary findings with abundance of inclusion-bearing cells and occurrence of multinuclear giant cells may be considered to confirm this diagnosis. Pulmonary infiltrates, appearing after the acute pleuritis had receded, were probably due to small primary bronchopneumonias caused by parainfluenza 2. Infiltrates appearing in the subsequent course without clinical symptoms are classified, on the other hand, as eosinophil pulmonary infiltrates. These, as well as the primary pleuritis, must be regarded as subsymptoms of Wissler's syndrome. Aetiologically, a bacterial cause has been sought for earlier. The present case, however, shows that Wissler's syndrome may be brought on by a virus infection. The clinical picture may possibly reflect an individual reaction of an allergic nature to various infections, both bacteriological and virological.
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PMID:Wissler's Syndrome Associated with Parainfluenza 2 Infection. 2560 84