Adult-onset Still's disease diagnostic study of choice: Difference between revisions

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==Diagnostic study of choice/ Diagnostic criteria==
==Diagnostic study of choice/ Diagnostic criteria==
 
The diagnosis of adult-onset Still's disease is made clinically along with supporting laboratory abnormalities and exclusion of other rheumatologic disorders, malignancy and infections. Three diagnostic criteria have been established in order to aid in the diagnosis of AOSD. Yamaguchi criteria is widely adopted. The following table outlines the major criteria system for the diagnosis of AOSD:
{| class="wikitable"
{| class="wikitable"
|'''Criteria'''
| rowspan="1" |'''Yamaguchi criteria'''
| rowspan="1" |'''Yamaguchi criteria'''
|'''Cush criteria'''
|'''Cush criteria'''
|'''Fautrel criteria'''
|'''Fautrel criteria'''
|-
|-
| rowspan="6" |Major criteria
| colspan="1" rowspan="1" |Arthralgia >2 weeks
| colspan="1" rowspan="1" |Arthralgia >2 weeks
| colspan="1" rowspan="1" |(2 points)
| colspan="1" rowspan="1" |Daily fever >39°
| colspan="1" rowspan="1" |Spiking fever ⩾39°
| colspan="1" rowspan="1" |Spiking fever ⩾39°
|-
|-
| colspan="1" rowspan="1" |Fever >39°, intermittent, ⩾1 week
| colspan="1" rowspan="1" |Fever >39°, intermittent, high spiking, ⩾1 week
| colspan="1" rowspan="1" |Quotidian fever >39°
| colspan="1" rowspan="1" |Still's (maculopapular) rash
| colspan="1" rowspan="1" |Arthralgia
| colspan="1" rowspan="1" |Arthralgia
|-
|-
| colspan="1" rowspan="1" |Typical rash
| colspan="1" rowspan="1" |Maculopapular rash on trunks and/or extremities
| colspan="1" rowspan="1" |Still's (evanescent) rash
| colspan="1" rowspan="1" |WBCs >12000/ml +ESR >40 mm/1st hour
| colspan="1" rowspan="1" |Transient erythema
| colspan="1" rowspan="1" |Transient erythema
|-
|-
| colspan="1" rowspan="1" |WBC >10 000 (>80% granulocytes)
| colspan="1" rowspan="1" |Leukocytosis- WBCs >10000 (>80% neutrophils)
| colspan="1" rowspan="1" |WBC >12.0+ESR >40 mm/1st h
| colspan="1" rowspan="1" |Νegative RF and ANA
| colspan="1" rowspan="1" |Pharyngitis
| colspan="1" rowspan="1" |Pharyngitis
|-
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |Νegative RF and ANA
| colspan="1" rowspan="1" |PMN ⩾80%
|-
|-
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |Carpal ankylosis
| colspan="1" rowspan="1" |Carpal ankylosis
| colspan="1" rowspan="1" |Glycosylated ferritin ⩽20%
| colspan="1" rowspan="1" |Polymorphonuclear cells ⩾80%
|-
|-
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |Glycosylated ferritin ⩽20%
|-
|-
| colspan="3" rowspan="1" |''Minor''
| rowspan="6" |Minor criteria
| colspan="3" rowspan="1" |
|-
|-
| colspan="1" rowspan="1" |Sore throat
| colspan="1" rowspan="1" |Sore throat
| colspan="1" rowspan="1" |(1 point)
| colspan="1" rowspan="1" |
|-
| colspan="1" rowspan="1" |Lymphadenopathy and/or splenomegaly
| colspan="1" rowspan="1" |Onset age <35 years
| colspan="1" rowspan="1" |Onset age <35 years
| colspan="1" rowspan="1" |Maculopapular rash
| colspan="1" rowspan="1" |Maculopapular rash
|-
|-
| colspan="1" rowspan="1" |LFT abnormal
| colspan="1" rowspan="1" |Lymphadenopathy
| colspan="1" rowspan="1" |Arthritis
| colspan="1" rowspan="1" |Arthritis
| colspan="1" rowspan="1" |Leucocytes ⩾10×109/l
| colspan="1" rowspan="1" |Leucocytes ⩾10×109/l
|-
|-
| colspan="1" rowspan="1" |(‐)ve ANA and RF
| colspan="1" rowspan="1" |Abnormal liver function tests (LDH, ALT, AST)
| colspan="1" rowspan="1" |Prodromal sore throat
| colspan="1" rowspan="1" |Prodromal sore throat
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
|-
|-
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |Negative ANA and RF
| colspan="1" rowspan="1" |RES involvement or abnormal LFTs
| colspan="1" rowspan="1" |Reticuloendothelial involvement or abnormal LFTs
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
|-
|-
| colspan="1" rowspan="1" |Hepatosplenomegaly
| colspan="1" rowspan="1" |Serositis
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |Serositis
|}
|}


Revision as of 20:09, 18 April 2018


Template:Adult-onset Still's disease

Overview

Diagnostic study of choice/ Diagnostic criteria

The diagnosis of adult-onset Still's disease is made clinically along with supporting laboratory abnormalities and exclusion of other rheumatologic disorders, malignancy and infections. Three diagnostic criteria have been established in order to aid in the diagnosis of AOSD. Yamaguchi criteria is widely adopted. The following table outlines the major criteria system for the diagnosis of AOSD:

Criteria Yamaguchi criteria Cush criteria Fautrel criteria
Major criteria Arthralgia >2 weeks Daily fever >39° Spiking fever ⩾39°
Fever >39°, intermittent, high spiking, ⩾1 week Still's (maculopapular) rash Arthralgia
Maculopapular rash on trunks and/or extremities WBCs >12000/ml +ESR >40 mm/1st hour Transient erythema
Leukocytosis- WBCs >10000 (>80% neutrophils) Νegative RF and ANA Pharyngitis
Carpal ankylosis Polymorphonuclear cells ⩾80%
Glycosylated ferritin ⩽20%
Minor criteria
Sore throat Onset age <35 years Maculopapular rash
Lymphadenopathy Arthritis Leucocytes ⩾10×109/l
Abnormal liver function tests (LDH, ALT, AST) Prodromal sore throat
Negative ANA and RF Reticuloendothelial involvement or abnormal LFTs
Hepatosplenomegaly Serositis

References

Template:WH Template:WS

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