Adult onset Still’s disease: 7 years experience at a tertiary care center from South India

Background: Adult onset Still’s disease (AOSD) is uncommon condition regarding which sparse published data are available from India. Methods: Retrospective study of 6 patients, who presented with pyrexia of unknown origin (PUO) seen over a 7-year period who were diagnosed to have AOSD after a thorough work-up. Results: Their mean age was 24.6 (range 18-38) years; there were four males. Mean duration of symptoms was 7.8 (range 3-5) weeks. In addition to prolonged fever, patients presented with rash, arthropathy, hepato-splenomegaly and peripheral lymphadenopathy. Laboratory evaluation revealed neutrophilic leukocytosis, hepatopathy, serositis, raised serum ferritin levels; anti-nuclear antibody and rheumatoid factor were negative in all. One patient developed acute respiratory distress syndrome and died. The remaining five patients were treated with non-steroidal anti-inflammatory drugs, oral corticosteroids, and hydroxy chloroquine and responded well to treatment. Conclusions: Increased awareness and a high index of suspicion is required for the diagnosis of AOSD. Though mortality is rare, it may occur due to complications.