Adult onset Still's dx Flashcards
most common features of adult onset Still’s dx in clinical presentation:
high fever
arthritis
transient rash
variable features on adult onset Still’s dx in clinical presentation:
LAD
sore throat
hepatomegaly, splenomegaly
pleuritis, pericarditis
Lab findings of adult onset Still’s dx?
leukocytosis
elevated inflammatory markers (ESR and C reactive protein)
markedly elevated ferritin
negative ANA and neg RF
can have normocytic anemia
can have thrombocytosis
can have elevated LFTs
lab that you should associate with acute adult onset still’s dx?
ferritin (will be in the thousands)
acute adult onset still’s dx rash is characterized by:
transient faint salmon colored macular rash that comes and goes with fever
not pruritic
acute adult onset still’s dx is a
systemic onset juvenile idiopathic arthritis and inflammatory disorder characterized by high daily recurring fevers and polyarthritis and neutrophilic leukocytosis
see a daily transient, non pruritic salmon colored rash that appears only with fever
what causes acute adult onset still’s dx
high levels of infalmmatory cytokines IL-1 and IL-6 and TNF alpha inhibitors
see elevated ESR and CRP
see high ferritin which is in 1000’s.
classic triade:
fever
arthalgia
rash
major Yamaguchi criteria:
four major:
fever at least 102.2 for at least one week
arthralgias lasting at least 2 weeks
non pruritic macular or maculopapular salmon color rash over the trunk and extremiteis that coincides with fever
leukcoytosis >10K and at least 80% granulocytes
minor Yamaguchi criteria
sore throat hepatomegaly/splenomegaly lymphadenopathy abnormal liver function tests negative ANA and RF
diagnosis of Acute onset still’s dx
need to have 5 criteria met and 2 must be major
treatment acute onset still’s disease is based on
symptom severity
ranges from NSAIDS for mild symptoms to high dose steroids and biologics for moderate to severe dx
follow up for acute onset still’s dx
3 month intervals with blood chemistreis
follow up CBC CMP and ferritin
acute febrile neutrophilic dermatosis
acute febrile neutrophilic dermatosis AKA Sweet’s syndrome
has sudden eruption of erythematous papules, plaques, or nodules that are painful and edematous.
See fever and leukocytosis with Sweet’s but skin biopsy will tell the difference between the two.
differential diagnosis for Still’s
acute febrile neutrophilic dermatosis AKA Sweet’s syndrome
non hodgkin lympohma - see night sweats, weight loss >10% body weight
polyarteritis nodosa (PAN) systemic necrotizing vasculitis and diagnosis is confirmed with skin biopsy.
