Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four adults with an illness similar to the systemic variant of juvenile rheumatoid arthritis seen in children (Still's disease) are described. All four had fever, an erythematous maculopapular rash, splenomegaly and arthritis. The arthritis was asymmetric and involved only a few joints simultaneously. Erosive arthritis developed in one patient. Three patients had a sore throat, two had pleurisy and pericarditis, and one had transient abnormalities of liver function. The laboratory features included anemia, leukocytosis and high leukocyte counts in the synovial fluid. High titres of rubella hemagglutination-inhibiting antibody were detected in two patients, one of whom was found to have rubella virus in the urine. Only one patient responded well to therapy with acetylsalicylic acid; the other three were given prednisone therapy, and two continue to require it.
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PMID:Adult-onset Still's disease. 45 6

Two cases of adult onset of Still's disease is in a 83-year-old and a 61-year-old women. Both cases complained of high fever, arthralgia, sore throat and maculae. Examinations on admission revealed leukocytosis and negative antinuclear antibody. Administration of prednisolone resulted in improvement of the clinical symptoms and laboratory data. In general, the onset of this disease is usually in early adulthood, but in these two cases the onset was at an advanced age. These results suggest that Still's disease of adult onset should be included in the differential diagnosis of fever of unknown origin, if the patient is elderly. In the treatment of the disease, proper attention to side effects of prednisolone and complications can be important.
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PMID:[Two cases of adult onset of Still's disease in the elderly]. 149 50

We have attempted to design classification criteria for adult Still's disease by analyzing the data obtained through a multicenter survey of 90 Japanese patients with this disease and of 267 control patients. The proposed criteria consisted of fever, arthralgia, typical rash, and leukocytosis as major, and sore throat, lymphadenopathy and/or splenomegaly, liver dysfunction, and the absence of rheumatoid factor and antinuclear antibody as minor criteria. Requiring 5 or more criteria including 2 or more major criteria yielded 96.2% sensitivity and 92.1% specificity. However, an exclusion process will be needed for an accurate classification, since this disease is relatively rare.
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PMID:Preliminary criteria for classification of adult Still's disease. 838 64

Adult onset Still's disease seems to be the adult form of Still's disease in children. The key symptoms of the disease are high spiking fever, arthritis and a macular or maculopapular, salmon-pink evanescent rash, almost always accompanied by neutrophilic leukocytosis and frequently by sore throat, intense myalgias, lymphadenopathy, splenomegaly and signs of serositis. Tests for IgM rheumatoid factor and antinuclear antibody are characteristically negative. With respect to haematologic abnormalities, the disease may give rise to several problems. First, there is a neutrophilic leukocytosis, which currently is unexplained, and often a normocytic normochromic anaemia, that may be profound. The anaemia has the characteristics of anaemia of chronic inflammatory disease. Both abnormalities disappear after effective treatment of the disease or at spontaneous remission. Secondly, there might be a problem to differentiate AOSD from malignant haematological disorders, including malignant lymphoma and leukaemia, especially when the picture is dominated by lymphadenopathy, splenomegaly, fever and leukocytosis. Although in rare cases the differential diagnosis is extremely difficult, diagnosis can mostly be made or excluded by peripheral blood smear staining, bone marrow biopsies and occasionally lymph node biopsy. Finally, like the juvenile counterpart, AOSD is occasionally complicated by sometimes life-threatening diffuse intravascular coagulation. Factors that might be important in the development of this complication include severe disease activity, liver abnormalities and particular drugs including salicylates, other NSAIDs and some slow-acting antirheumatic drugs. Prompt therapy, including withdrawal of the drug, corticosteroids and sometimes anticoagulant therapy have been successfully applied to most patients.
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PMID:Adult-onset Still's disease. 175 84

Physical findings, laboratory data, treatments and prognosis were investigated in detail using 26 Japanese childhood Still's disease (CHSD) patients and 19 Japanese adult onset Still's disease (AOSD) patients as the subjects. High spiking fever and arthritis were present in all the patients. Seventy and seven percent of CHSD and 53 percent of AOSD had polyarthritis (the number of joints involved being 5 or more during the first 6 months of the disease). A comparison of the groups showed no significant difference in the initial systemic manifestations except for sore throat (CHSD: AOSD; 19%: 68%). Initial laboratory data were the same for these groups except for serum iron levels (CHSD: AOSD; 20.8 +/- 13.7 micrograms/dl: 83.0 +/- 54.2 micrograms/dl). As to joints and physical prognosis, the results were also the same for CHSD and AOSD under the similar treatment. On the basis of these data, we conclude that CHSD and AOSD are of the same disease entity so far as the present clinical features are concerned.
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PMID:[Comparison of clinical features of childhood and adult onset Still's disease]. 176 45

Clinical and laboratory manifestations, disease course, outcome, and HLA associations were studied in an inception cohort of 62 subjects with adult Still's disease (ASD) from 5 Canadian universities. Twenty-eight patients (45%) were female and the median age at disease onset was 24 years. In general, the clinical features observed in our patients were identical to those in other published series. However, significantly higher frequencies of sore throat (92%), weight loss (76%), lymphadenopathy (74%), pleuritis (53%), pneumonitis (27%), and abdominal pain (48%) were noted in our patients compared to those in a recent literature review. Liver involvement with hepatomegaly (44%) or abnormal liver function tests (LFTs) (76%) was common and was responsible for the 2 deaths attributed to Still's disease in our series. Severe liver failure always occurred in conjunction with aspirin or NSAID therapy. Therefore, whether or not aspirin or other NSAIDs are used, we recommend close monitoring of LFTs in patients with ASD, especially early in the disease course. Laboratory manifestations were similar to those already reported. Leukocytosis (greater than or equal to 15,000/mm3) was present in 50 patients (81%), a normochromic, normocytic anemia (hemoglobin less than or equal to 10 g/dl) in 42 (68%), and an elevated ESR in all. The mean follow-up of the 62 patients was 70 months (range, 2-163). Twenty-one patients (34%) had a self-limited disease course, 15 (24%) an intermittent course, and 22 (36%) a chronic disease course. Four patients (6%) died, and 2 of these deaths were attributed to Still's disease. For those patients who experienced a recurrence of ASD, the flares were usually of shorter duration and milder in severity than the initial episode. No initiating factor for disease exacerbation was identified in our patients. Although 22 of 62 patients (36%) had a chronic disease course, 52 (90%) were in ARA Functional Class I, and only 4 and 2 patients were in ARA Functional Class II and III, respectively. Patients with Still's disease had higher scores than the controls on the Pain (P less than 0.01) and Physical Disability (P less than 0.05) subscales of Arthritis Impact Measurement Scales health status questionnaire. Joint radiographs performed at the follow-up evaluation disclosed typical carpometacarpal and intercarpal involvement in 16 of 39 patients. In our series, HLA-B17, B18, B35, and DR2 were significantly associated with ASD. Three significant predictors of an unfavorable outcome, either a chronic disease course or a longer time to clinical remission, were identified.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Adult Still's disease: manifestations, disease course, and outcome in 62 patients. 200 77

We reported a case of adult Still's disease accompanied by pericarditis, pleuritis and extensive pneumonitis with respiratory failure. A 59-year-old woman was admitted to our hospital because of high grade fever and sore throat. She had a spiking fever between 38 degrees C and 40 degrees C. Surface lymph nodes were palpable in the neck and inguinal lesions and hepatosplenomegaly was recognized. Laboratory data showed a marked increase in peripheral leukocytes, erythrocyte sedimentation rate, liver dysfunction and anemia. Serologic tests were negative for various autoantibodies and rheumatoid factor. She received various antibiotics, but there was no improvement. Later, a rheumatoid rash which suggested adult Still's disease developed. The diagnosis of adult Still's disease was made by skin biopsy and clinical course. Although pericarditis, pleuritis and extensive pneumonitis were accompanied with severe respiratory failure, her symptoms improved with steroid pulse-therapy. A transbronchial lung biopsy revealed moderate fibrosis and cell infiltration in alveoli.
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PMID:[A case of adult Still's disease with severe pulmonary complications]. 258 6

A 71 year-old man with adult onset Still's disease was admitted to our hospital because of fever, sore throat, myalgia and macular nonpruritic salmon pink eruption. He was treated with prednisolone, 40 mg daily and these symptoms disappeared. When the dose of prednisolone was reduced to 30 mg daily, he began to notice fever. 5 days later he developed adult respiratory distress syndrome (ARDS). The dose of prednisolone was increased to 50 mg daily and oxygen administration was started. All symptoms began to improve immediately and the dose of prednisolone was decreased to 40 mg daily. 10 days later he noticed fever and skin rash. Laboratory investigation showed platelet counts of 69,000/mm3, a ferritin of 37,000 ng/ml, and increased fibrinogen degradation product, indicating increased activity of adult onset Still's disease associated with disseminated intravascular coagulation (DIC). The dose of prednisolone was again increased to 60 mg daily, and 100 mg of nafamostat mesilate was administrated intravenously. All above symptoms associated with adult onset Still's disease and DIC disappeared. The dose of prednisolone was gradually decreased and the clinical course was uneventful with daily administration of 10 mg of prednisolone. Although there are a couple of case report which described the association of adult onset Still's disease with either ARDS or DIC, the association of adult onset Still's disease with both ARDS and DIC have not been reported yet.
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PMID:[A case of adult onset Still's disease complicated with adult respiratory distress syndrome and disseminated intravascular coagulation]. 755 55

The present study compared the clinical and laboratory picture, the disease course and outcome in 31 patients having adult onset Still's disease (AOSD) with 23 patients having juvenile onset Still's disease (JOSD). The median age at disease onset was 20 and 7 yr for AOSD and JOSD patients, respectively. On analysing and comparing our data on these two groups, no significant differences emerged except that adults had a significantly lower time interval from disease onset to remission as compared to juveniles. Upon comparison of data on our AOSD patients with that published from abroad, rash, adenopathy and sore throat were less frequent. No clinical or laboratory variables were found to predict the subsequent disease course and outcome in either group. The functional outcome was good in about 70% of both groups and mortality was low. It is concluded that the clinical picture and outcome in AOSD is similar to that of JOSD.
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PMID:Adult onset Still's disease in northern India: comparison with juvenile onset Still's disease. 778 71

The adult Still's disease (ASD) is an uncommon inflammatory systemic disorder which affects the young adult. It is characterized by high spiking fever, vanishing rash, oligopolyarthritis, neutrophilic leucocytosis, negative titers for rheumatoid factor and antinuclear antibodies. Polyserositis, sore throat, uveitis are sometimes present and in one third of the cases it is possible to find hepato-splenomegaly with lymph node enlargement. G. Still first described the disease in child, in 1897, and in the adult it was recognized as a nosologic entity more than 70 years later. The ASD diagnosis is difficult and it is possible after the exclusion of many other diseases. Clinical manifestation are all nonspecific. In particular the presence of adenopathy, hepato-splenomegaly may suggest the possibility of a malignant lymphoma. Important exclusions include many other diseases such as the rheumatic fever, periodic fever, Lyme disease. At the same time a probable diagnosis of ASD should be considered in all the cases of high fever with rash, arthritis, neutrophilic leucocytosis or in the cases of fever of unknown origin (FUO). The prognosis is considered overall benign. The disease is usually sensible to salicylate treatment, even but the association with corticosteroids or, sometimes, with cytotoxic therapy is often required.
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PMID:[Still's disease in the adult]. 802 9


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