Expand the differential…think beyond rheumatoid arthritis

Schwartz, Cody; Zaidi, Zareen

doi:10.1136/bcr-2018-225618

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…In this study, the incidence rate of AOSD was 0.625 cases per year which is lower than those calculated by other epidemiological studies [1]. The observed variation in results may be due to false diagnosis and subsequent treatment of patients for alternative medical conditions.…”

Section: Discussioncontrasting

confidence: 72%

Clinical Spectrum of Adult-Onset Still’s Disease in Patients Presenting At A Tertiary Care Hospital in Pakistan: A 16-Year Follow-Up Study

Riaz,

Arshad,

Baqir

et al. 2023

Preprint

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Objectives Adult-onset Still’s Disease (AOSD) is a rare systemic auto-inflammatory disorder with a low incidence rate and limited data. This study aims to lay down the clinical and laboratory spectrum, associated complications, and outcomes of patients who presented to a tertiary care center – in order to identify any regional variation in the presentation and enable physicians to develop a thought process in patients without characteristic features. Materials and Methods We reviewed the records of patients from January 2005 - February 2021 who presented with symptoms consistent with AOSD, using the Yamaguchi criteria. The patients’ clinical symptoms, laboratory values, therapeutic management, complications, and outcomes were analysed. Descriptive statistics were produced to illustrate the pattern of the disease. Results The mean age of patients was 37.7 years, with a male to female ratio of 1:1. Fever and arthralgia was seen in 90%, a salmon-coloured rash in 60%, and leukocytosis in 80%. 30% presented with a sore throat and recent lymphadenopathy, 40% with hepatomegaly and/or splenomegaly on imaging, 100% with abnormal liver function tests. Steroids were used as first-line treatment. Most patients did not present with common, previously reported, complications of AOSD. Conclusions The clinical aspects in this study are, to a large part, comparable to those seen in other parts of the world. Thus, a comprehensive analysis of AOSD would enable physicians to broaden their minds and keep it as a top differential in atypical presentations – enhancing patient care by preventing a delay in diagnosis and initiation of prompt management.

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Section: Discussioncontrasting

confidence: 72%

Clinical Spectrum of Adult-Onset Still’s Disease in Patients Presenting At A Tertiary Care Hospital in Pakistan: A 16-Year Follow-Up Study

Riaz,

Arshad,

Baqir

et al. 2023

Preprint

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“…Furthermore, skin rashes can indicate a severe form of rheumatoid disease or even an aggressive progression of vasculitis, which warrants immediate diagnosis and intervention [ 10 ]. Such conditions require early detection and treatment because of the risks associated with disease progression and complications [ 11 ]. Immediate skin biopsy can elucidate the exact nature and severity of the condition and guide appropriate therapeutic approaches.…”

Section: Discussionmentioning

confidence: 99%

Acute Onset Rheumatoid Vasculitis With Polyarthritis and Erythema: A Case Report

Amao,

Koda,

Ofuji

et al. 2023

Cureus

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We present the case of a woman in her 70s who was diagnosed with rheumatoid vasculitis (RV) after initially presenting with systemic joint pain and erythema. RV, a rare complication of rheumatoid arthritis, involves inflammation of blood vessels, leading to various skin manifestations. The patient's complaints included fever, generalized joint pain, and skin manifestations that initially resembled erythema multiforme. However, a skin biopsy revealed vasculitis, which guided the RV diagnosis. Although rheumatoid arthritis primarily affects the joints, systemic implications such as RV can arise in rare cases. This case underscores the importance of a holistic and meticulous diagnostic approach, especially in older patients, as early detection and treatment are crucial for managing disease progression and associated complications. Collaborative care involving multidisciplinary teams is vital to achieving optimal outcomes in complex cases.

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“…Adult-onset Still's disease (AOSD) is a rare systemic auto-in ammatory disorder characterized by a triad of fever, migratory arthralgia (Arthritis) and salmon-colored rash. The diagnosis is made by the Yamaguchi criteria [1]. Epidemiological studies on AOSD are limited due to its scarcity; however recent studies have shown an increased incidence and prevalence in AOSD due to increased awareness.…”

Section: Introductionmentioning

confidence: 99%

Clinical spectrum of adult-onset Still’s disease in patients presenting at a tertiary care hospital in Pakistan: A 16-year retrospective descriptive study

Riaz,

Baqir,

Isra

et al. 2023

Preprint

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Introduction: Adult-onset Still's Disease (AOSD) is a rare systemic auto-inflammatory disorder with limited available data and regional variations in presentation. This study aims to shed light on the clinical and laboratory spectrum and associated complications of AOSD patients at a tertiary care center. The goal is to facilitate early diagnosis and management in cases lacking characteristic features. Methods: We conducted a retrospective review of patient records from January 2005 to February 2021, utilizing the Yamaguchi criteria for AOSD diagnosis. Clinical symptoms, laboratory values, therapeutic approaches and complications were analyzed. Descriptive statistics were employed to illustrate disease patterns. Results: The study included patients with a mean age of 37.6 years, with a male-to-female ratio of 3:5. Fever and arthralgia were prevalent in 100% of cases, while a salmon-colored rash was observed in 62.5%, and leukocytosis in 75%. Additional symptoms included sore throat and recent lymphadenopathy in 37.5%, hepatomegaly and/or splenomegaly on imaging in 50%, and abnormal liver function tests in 87.5% cases. Steroids were the primary first-line treatment. Notably, most patients did not exhibit the common complications previously reported in AOSD. Conclusion: The clinical findings in our study closely resemble those reported in other regions, emphasizing the need for a comprehensive analysis of AOSD. This study underscores the importance of considering AOSD as a potential diagnosis, even in atypical presentations, to enhance patient care by minimizing delays in diagnosis and enabling prompt management. Key points • This study presents the first national data on AOSD in Pakistan • AOSD mostly affects younger adults, with a mean age of 37.6 years • Common AOSD symptoms include fever, arthralgia, leukocytosis, high ferritin levels, and abnormal liver function, but the rash's prevalence varies by region.

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Expand the differential…think beyond rheumatoid arthritis

Cited by 5 publications

References 19 publications

Clinical Spectrum of Adult-Onset Still’s Disease in Patients Presenting At A Tertiary Care Hospital in Pakistan: A 16-Year Follow-Up Study

Clinical Spectrum of Adult-Onset Still’s Disease in Patients Presenting At A Tertiary Care Hospital in Pakistan: A 16-Year Follow-Up Study

Acute Onset Rheumatoid Vasculitis With Polyarthritis and Erythema: A Case Report

Clinical spectrum of adult-onset Still’s disease in patients presenting at a tertiary care hospital in Pakistan: A 16-year retrospective descriptive study

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