Investigation of demographic, clinical, laboratory and treatment characteristics in adult still patients by retrospective method

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease characterized by high fever, a disappearing salmon pink rash, and arthritis, often accompanied by sore throat, myalgia, lymphadenopathy, splenomegaly, and neutrophilic leukocytosis. Although the underlying causes of AOSD have not been fully elucidated, it has been suggested that stressful life events related to work, family and health are also a potential trigger for AOSD. A better understanding of the cellular and molecular mechanisms involved in the pathogenesis of AOSD will allow the development of new strategies in the treatment of the disease. A total of 51 patients, aged between 18-60 years, who were diagnosed with AOSD according to the criteria of Yamaguchi et al., who applied to Rheumatology outpatient clinic at Dicle University Faculty of Medicine, Department of Physical Medicine and Rehabilitation and Gazi Yaşargil Research and Training Hospital between 2000-2022, were included in the study. Information about the basic characteristics of the patients, laboratory tests, treatment and complications were collected retrospectively. Demographic, clinical and treatment characteristics of the patients were compared according to the previously prepared protocol. 37 (72.5%) of our patients were female and the mean age was 36.5±10.2 years. Fever, rash, arthritis, sore throat and myalgia were the most common clinical findings, and the most common laboratory findings were leukocytosis, acute phase reactants and increased ferritin levels. We compared our patients by dividing them into 2 groups according to their gender and whether they took biological agents. No significant difference was found between the female and male groups in terms of clinical features, except for the rash (p>0.05). Rash was more common in women than men (p=0.04). Anemia was more common in women than men (p=0.041). Diagnosis delay was higher in the group using biologic agents (p=0.01). All 4 patients who developed complications were women. Our study was retrospective and the number of patients was relatively limited, since patients whose data could not be fully reached were not included in the study. It was seen that the disease progresses more complicated in women and the use of biologic agents was more necessary in patients with delayed diagnosis. Increasing AOSD awareness in cases of fever of unknown origin in terms of early diagnosis and treatment will prevent complications and aggressive expensive drug use. For this, prospective studies with larger AOSD patients are needed. Keywords: Adult-onset Still Disease, Arthritis, Rash, Retrospective, Ferritin