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ADOLESCENT-ONSET STILL'S DISEASE : CHARACTERISTICS AND EVOLUTION OF 9 CASES IN COMPARISON WITH ADULT AND JUVENILE-ONSET STILL DISEASE PATIENTS.

 

 F Luthi, P Zufferey, M F Hofer, A K So. Lausannne, VD, Switzerland, Lausanne, VD, Switzerland.

According to an age at onset before or after 16 years, Still Disease is usually classified into Adult (AOSD) or Juvenile Still Disease (JOSD)also renamed Idiopathic Arthritis of Childhood :systemic arthritis (IAC-sa). Few studies have compared both entities. They concluded that there were very few differences and suggested that AOSD was probably just a prolongation of IAC-sa.

The goal of this study was to confirm this hypothesis by comparing patients with IAC-sa and AOSD paying special attention to a subgroup of patients classified as Adolescent-Onset Still disease(age at onset between 13 and 18 years).

Among the 23 patients with Still disease diagnosed in our hospital during the ten last years (13 AOSD, 10 IAC-sa ) 9 had an age at onset between 13 and 18 years old. Clinical articular and systemic manifestations, laboratory values, treatments and complications were compared in the three subgroups. Functional evolution (HAQ and /or CHAQ at the end of follow-up) was also compared .

The mean follow-up was 4,7 years (3,5 for IAC-sa, 6,3 for AOSD, and 3,5 for the adolescent group). There were no significant difference between IAC-sa and AOSD patients in the presentation of the illness, in the joint lesions, the responses to treatment or in the functional prognosis.Proximal articular involvement especially the hip (4/23patients) was associated with poor functional prognosis. Some systemic manifestations or complications were more common in the adult group (serositis, macrophage activation syndrome).Adolescent Still disease patients fulfilled ARA for JOSD, the recent Durban criteria for IAC-sa and Yamagushi criteria for AOSD. Their initial presentation and evolution was similar to younger IAC-sa or older AOSD patients.

In conclusion, our patients with Adolescent onset Still disease do not differ either from Juvenile or Adult onset patients.This emphasizes the opinion that IAC-sa and AOSD are probably part of a continous spectrum.

ACR Poster Session E: Miscellaneous Rheumatic Diseases (8:00 AM-9:30 AM)

Presentation Date: Tuesday, November 16, 1999, Time: 8:00AM, Room: Hall B

 

 

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