Adult-onset Still’s disease in the clinical practice of infectious disease physician
DOI: 10.32364/2587-6821-2020-4-11-705-709
T.V. Kharlamova1, T.Yu. Smirnova2, V.P. Golub1, I.V. Barysheva1, D.S. Konnov1
1Peoples’ Friendship University of Russia, Moscow, Russian Federation
2Infectious Diseases Clinical Hospital No.2, Moscow, Russian Federation
Adult-onset Still’s disease (AOSD) is a rare multisystem disease of unknown etiology. According to the literature, AOSD incidence in the world is 0.1–0.4 per 100 thousand population and it has two age-related peaks: the first peak — young age (15–25 years), the second — in persons aged 35–46 years. The causes and pathogenetic mechanism of AOSD are not established. The infectious pathology nature has not received proper scientific confirmation. According to modern concepts, this disease belongs to the group of auto-inflammatory, occurring without autoimmune disorders. It was found that patients with AOSD have a T-cell regulation disorder, increased production of the proinflammatory cytokine, the long-term persistence of which leads to the occurrence of fever and aseptic inflammation in various organs and tissues. The main criteria for this nosology are young age, persistent fever, arthritis, maculopapular rash, elevated ferritin le vel, neutrophilic leukocytosis, seronegative rheumatoid arthritis. Concomitant diseases include polyserositis, lymphadenopathy, hepatosplenomegaly, and nasopharyngeal infection. The article presents a clinical case of AOSD verified in a young woman at the Infectious Diseases Clinical Hospital. The difficulties of diagnostics are described, taking into account the variety of symptoms and the absence of pathognomonic disease signs.
Keywords: Adult-onset Still’s disease, fever, auto-inflammatory disease, arthritis, maculopapular rash, ferritin.
For citation: Kharlamova T.V., Smirnova T.Yu., Golub V.P. et al. Adult-onset Still’s disease in the clinical practice of infectious disease physician. Russian Medical Inquiry. 2020;4(11):705–709. DOI: 10.32364/2587-6821-2020-4-11-705-709.
About the authors:
Tatiana V. Kharlamova — Cand. of Sci. (Med.), Assistant of the Department of Infectious Diseases with courses of Epidemiology and Phthisiology, Peoples’ Friendship University of Russia, 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0003-4261-3000.
Tatiana Yu. Smirnova — Head of the 3rd Infectious Diseases Department, Infectious Diseases Clinical Hospital No.2, 15, 8th Sokolinoi Gory str., Moscow, 105275, Russian Federation; ORCID iD 0000-0002-6461-0444.
Veniamin P. Golub — Cand. of Sci. (Med.), Associate Professor of the Department of Infectious Diseases with courses of Epidemiology and Phthisiology, Peoples’ Friendship University of Russia, 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0002-7725-6368.
Irina V. Barysheva — Senior Lecturer of the Department of Infectious Diseases with courses of Epidemiology and Phthisiology, Peoples’ Friendship University of Russia, 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0002-3543-9086.
Danila S. Konnov — Cand. of Sci. (Med.), Assistant of the Department of Infectious Diseases with courses of Epidemiology and Phthisiology, Peoples’ Friendship University of Russia, 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0003-0140-1255.
Contact information: Tatyana V. Kharlamova, e-mail: tatykharlam@yandex.ru. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 14.10.2019, revised 09.11.2019, accepted 28.11.2019.
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