Adult-Onset Still's Disease: A Review

Adult-onset Still's disease (AOSD) is an uncommon inflammatory condition characterised by high fever, leukocytosis with neutrophilia, arthralgia and skin rash. Diagnosis is often clinical, and it is always necessary to exclude common disease mimics such as infections, malignancies and other rheumatic diseases. Ferritin and glycosylated ferritin are useful adjuncts to aid in the diagnosis of AOSD. Important complications to consider include fulminant hepatitis, disseminated intravascular coagulopathy and hemophagocytic syndrome. Mainstay treatment of AOSD is often with glucocorticoids. Other agents that can also be used include methotrexate, and biologic therapy, such as tumor necrosis factor-α (TNF-α) blockers and interleukin-1 (IL-1) inhibitors. A retrospective review of patients diagnosed with AOSD admitted to Singapore General Hospital (SGH) was performed, and their disease characteristics and laboratory findings were compared with that of previous published cohorts.