Clinical features of elderly-onset Adult-onset Still's disease. Issue 4 (4th July 2021)

• Record Type: Journal Article
• Authors: Maruyama, Akihito; Kokuzawa, Ayako; Yamauchi, Yusuke; Kirino, Yohei; Nagai, Hideto; Inoue, Yasushi; Ota, Toshiyuki; Chifu, Yutaka; Inokuchi, Satomi; Koarada, Syuichi; Ohta, Akihide; Iwamoto, Masahiro; Tada, Yoshifumi
• Is Part Of: Modern rheumatology. Volume 31:Issue 4(2021)
• Page Start: 862
• Page End: 868
• Publication Date: 2021-07-04
• Subjects: Adult-onset Still's disease -- complication -- elderly-onset -- remission; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1080/14397595.2020.1829340
• Languages: English
• ISSNs: 1439-7595

Abstract

Abstract: Objectives: To clarify the characteristics of patients with elderly-onset Adult-onset Still's disease (AOSD). Methods: Patients were classified into elderly-onset (>60 years: 47 patients) and younger-onset (≤60 years: 95 patients) groups according to their age at diagnosis of AOSD. Clinical features, treatments, and prognosis were compared between the elderly-onset and younger-onset groups. Results: In the elderly-onset group, compared with the younger-onset group, typical skin rashes were less frequent (21.3% vs 58.9%, respectively; p < .0001), whereas pleuritis (27.7% vs 7.4%, respectively; p = .0011) and disseminated intravascular coagulation (19.1% vs 2.1%, respectively; p = .0004) were more frequent, and serum ferritin levels were higher (median 12, 700 ng/ml vs 2526 ng/ml, respectively; p < .0001). Overall survival and AOSD-related survival were reduced ( p = .0006 and p = .0023, respectively) and drug-free remission was less frequent ( p = .0035) in the elderly-onset group compared with the younger-onset group. Conclusions: Our results demonstrated that elderly-onset AOSD patients had several characteristics that differed from younger-onset AOSD patients, including less typical skin lesions, more AOSD-related complications, higher ferritin levels, and poorer prognoses.