Adult-Onset Still's Disease (AOSD)
Rare inflammatory ...

Adult-Onset Still's Disease (AOSD)

Rare inflammatory disorder of unknown etiology, difficult to diagnose because of heterogenous presentation. 

Must rule out other likely conditions (autoimmune, infectious, malignant) to diagnose.

Pathogenesis: Unclear, but innate immune response implicated. Elevated IL-18, IL-6, TNF-a, ? Genetic susceptibility, infectious triggers

Presentation: High spiking fever, evanescent salmon-colored maculopapular rash, arthritis, neutrophilic leukocytosis. Life-threatening complications in 15-20%

     Monocyclic: single episode (30%)

     Systemic AOSD: high fever, CRP, AST+ALT, ferritin. Innate immunity (30%)

     Chronic articular AOSD: F>M, low ferritin, arthritis and chronic synovitis (40%)

Treatment: NSAIDs, steroids (acutely), DMARDS (steroid-sparing), IVIG, cyclophosphamide, biologics

- BWH Medicine Chiefs @BrighamChiefs

#AdultOnset #Stills #Disease #AOSD #rheumatology #diagnosis #management #treatment
Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: | Twitter:
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