Resumen
En México la Enfermedad de Still del Adulto (ESA), es una causa de Fiebre de origen desconocido (FOD), en este estudio se describen casos de FOD en los que se concluyó ESA, con el objetivo de conocer las características clínicas y bioquímicas asi como describir el índice neutrófilo-linfocito (INL).
Método: Estudio observacional de una serie de 24 casos con ESA.
Resultados: 72% fueron mujeres, mediana de edad 43 años (37.7-59.7) las manifestaciones más frecuentes fueron rash clásico (84%) y artralgias (100%). Todos tuvieron factor reumatoide, anticuerpos antinucleares negativos e hiperferritinemia, 83% tuvieron un INL>3.08. El tratamiento más empleado fue la combinación de metrotexate y corticoesteroides, 7 pacientes ameritaron terapia biológica, uno presento reacción de hipersensibilidad.
Conclusion: La ESA es una enfermedad que debe sospecharse ante la presencia de fiebre, rash, artralgias, hiperferritinemia e INL>3.08, en el abordaje de FODReferencias
- Bywaters EG Still's disease in the adult. Annals of the Rheumatic Diseases 1971;30:121-133.
- Pak, S., & Pham, C. (2017). Delay in the Diagnosis of Adult-Onset Still’s.
- Wang, M. Y., Jia, J. C., Yang, C. D., & Hu, Q. Y. (2019). Pathogenesis, disease course, and prognosis of adult-onset Still's disease: an update and review. Chinese medical journal, 132(23), 2856.https://doi.org/10.1097/CM9.0000000000000538
- Louthrenoo, W., Aramsareewong, T., & Sukitawut, W. (2001). Adult onset Still’s disease: Clinical features and outcome in 16 Thai patients. JCR: Journal of Clinical Rheumatology, 7(5), 301-307.
- Fautrel, B., Le Moël, G. I. S. È. L. E., Saint-Marcoux, B. E. R. N. A. D. E. T. T. E., Taupin, P. I. E. R. R. E., Vignes, S. T. É. P. H. A. N. E., Rozenberg, S. Y. L. V. I. E., ... & Bourgeois, P. I. E. R. R. E. (2001). Diagnostic value of ferritin and glycosylated ferritin in adult onset Still's disease. The Journal of rheumatology, 28(2), 322-329.
- Schwarz-Eywill, M., Heilig, B., Bauer, H., Breitbart, A., & Pezzutto, A. (1992). Evaluation of serum ferritin as a marker for adult Still's disease activity. Annals of the rheumatic diseases, 51(5), 683-685. https://doi.org/10.1136/ard.51.5.683
- Mimura, T., Kondo, Y., Ohta, A., Iwamoto, M., Ota, A., Okamoto, N., ... & Nishimoto, N. (2018). Evidence-based clinical practice guideline for adult Still’s disease. Modern rheumatology, 28(5), 736-757. doi:10.1080/14397595.2018.1465633
- Casarrubias-Ramírez, M., Alfaro-Mejía, J. A., De Santiago-Leaños, J., Mendoza-Álvarez, S. A., Pineda-Galindo, L. F., & Vera-Lastra, O. L. (2015). Fiebre de origen oscuro, comparación de dos series con 26 años de diferencia. Revista Médica del Instituto Mexicano del Seguro Social, 53(S1), 6-17.
- Crispín, J. C., Martínez-Baños, D., & Alcocer-Varela, J. (2005). Adult-onset Still disease as the cause of fever of unknown origin. Medicine, 84(6), 331-337.
- Seo, J. Y., Suh, C. H., Jung, J. Y., Kim, A. R., Yang, J. W., & Kim, H. A. (2017). The neutrophil-to-lymphocyte ratio could be a good diagnostic marker and predictor of relapse in patients with adult-onset Still's disease: A STROBE-compliant retrospective observational analysis. Medicine, 96(29).doi:10.1097/MD.0000000000007546
- Park HJ, Ha YJ, Pyo JY, Park YB, Lee SK, Lee SW. Delta neutrophil index as an early marker for differential diagnosis of adult-onset Still's disease and sepsis. Yonsei Med J. 2014;55(3):753-759. doi:10.3349/ymj.2014.55.3.753
- Riera E, Olivé A, Narváez J, et al. Adult onset Still's disease: review of 41 cases. Clin Exp Rheumatol. 2011;29(2):331-336.
- Kim YJ, Koo BS, Kim YG, Lee CK, Yoo B. Clinical features and prognosis in 82 patients with adult-onset Still's disease. Clin Exp Rheumatol. 2014;32(1):28-33.
- Wang Y, Hunt K, Nazareth I, et al Do men consult less than women? An analysis of routinely collected UK general practice data BMJ Open 2013;3:e003320. doi: 10.1136/bmjopen-2013-003320
-. Hu QY, Zeng T, Sun CY, et al. Clinical features and current treatments of adult-onset Still's disease: a multicentre survey of 517 patients in China. Clin Exp Rheumatol. 2019;37 Suppl 121(6):52-57.
- Franchini S, Dagna L, Salvo F, Aiello P, Baldissera E, Sabbadini MG. Adult onset Still's disease: clinical presentation in a large cohort of Italian patients. Clin Exp Rheumatol. 2010;28(1):41-48.
- Stéphane Mitrovic & Bruno Fautrel (2018) Complications of adult-onset Still’s disease and their management, Expert Review of Clinical Immunology, 14:5, 351-365, DOI: 10.1080/1744666X.2018.1465821
- SAYED, Md Anwar; CHOWDHURY, Suman. Systemic Lupus Erythematosus (SLE) in a male patient previously diagnosed as Adult Onset Still’s Disease: A Case Report. Bangladesh Journal of Medicine. 2019, 30 (2), 100-103. https://doi.org/10.3329/bjmed.v30i2.41538
-Natalya Ellis, Gagandeep Takhar, 23. Adult-onset Still’s disease presenting as SLE, Rheumatology Advances in Practice, Volume 3, Issue Supplement_1, September 2019, rkz027.007, https://doi.org/10.1093/rap/rkz027.007
- Efthimiou, P., Paik, P. K., & Bielory, L. (2006). Diagnosis and management of adult onset Still's disease. Annals of the rheumatic diseases, 65(5), 564–572. https://doi.org/10.1136/ard.2005.042143
- Vercruysse, F., Barnetche, T., Lazaro, E. et al. Adult-onset Still’s disease biological treatment strategy may depend on the phenotypic dichotomy. Arthritis Res Ther 21, 53 (2019). https://doi.org/10.1186/s13075-019-1838-6
- Franchini S, Dagna L, Salvo F, Aiello P, Baldissera E, Sabbadini MG. Efficacy of traditional ad biologic agents in different clinical phenotypes of adult-onset Still's disease. Arthritis Rheum. 2010;62(8):2530-2535. doi:10.1002/art.27532
-Bartoloni E, Alunno A, Luccioli F, Santoboni G, Gerli R. Successful treatment of refractory adult-onset Still's disease with anti-CD20 monoclonal antibody. Clin Exp Rheumatol. 2009;27(5):888-889.
- Park EH, Lee EY, Shin K, Kim HA. Tocilizumab-induced anaphylaxis in patients with adult-onset Still's disease and systemic juvenile idiopathic arthritis: a case- based review. Rheumatol Int. 2020;40(5):791-798. doi:10.1007/s00296-019-04456-9
- Justet, A., Neukirch, C., Poubeau, P., Arrault, X., Borie, R., Dombret, M.-C., & Crestani, B. (2014). Successful rapid tocilizumab desensitization in a patient with Still disease. The Journal of Allergy and Clinical Immunology: In Practice, 2(5), 631–632. doi:10.1016/j.jaip.2014.04.015

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
Derechos de autor 2021 Revista Alergia México