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Clinical Analysis and Literature Review of 28 Adult Onset Still's Disease Cases

ZHOU Qiang(The Seventh Hospital of Zhengzhou,Zhengzhou 450012,CHINA)  
Objective To study the clinical characteristics of Adult Onset Still's Disease(AOSD).Methods Twenty-eight cases with AOSD were collected from 1990 to 2011,and their clinical manifestations and laboratory tests were analyzed retrospectively.Results All twenty-eight cases had fever.Twenty-four cases had rash,twenty cases had arthralgia.Some symptoms,such as pharyngalgia,enlargement of lymph node and hepatosplenomegaly,were presented in some patients.By laboratory test,the number of white blood cell(WBC) and the level of C reactive protein(CRP) increased in all twenty-eight patients.Twenty-five patients had anaemia.Eighteen patients got a raise of alanine aminotransferase(ALT) or aspartate aminotransferase(AST).Eighteen cases had bone marrow aspiration showing infectivity while bacterial cultures were negative.Glucocorticoid and non-steroidal anti-inflammatory drug(NSAID) were the first choice for treatment combined with immunodepressant if possible.Symptoms in all twenty-eight patients released after treatment for two weeks to four months.Two patients re occurred in 1 year and 16 years later respectively,and had their symptom released after glucocorticoid treatment.Conclusion AOSD is a disease with varied manifestations,with high misdiagnosed possibility.Most patients have favorable prognosis,but some of them will recur.It is necessary to follow up intensely.
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