| Abstract | Adult-onset Still's disease is a rare systemic inflammatory disease of unknown etiology, characterized by daily high, spiking fevers, evanescent rash, and arthritis. There is no single diagnostic test for adult-onset Still's disease; rather, the diagnosis is based on clinical criteria and necessitates the exclusion of infectious, neoplastic, and other 'autoimmune' diseases. Proinflammatory cytokines such as interleukin (IL)-1, IL-6, and IL-18, interferon-gamma, tumor necrosis factor, and macrophage colony-stimulating factor are elevated in patients with adult-onset Still's disease and are thought to have a major role in the pathogenesis of the disease. Treatment consists of nonsteroidal anti-inflammatory drugs, corticosteroids, immunosuppressants (methotrexate, gold, azathioprine, leflunomide, cyclosporin, and cyclophosphamide), intravenous immunoglobulin, and cytokine (tumor necrosis factor, IL-1 and IL-6) inhibitors. Recent advances in basic immunology have enhanced our ability to hinder the pathogenic mechanisms associated with adult-onset Still's disease and have led to a paradigm shift where targeted treatments have an increasingly important role. |
| Authors | Petros Efthimiou, Apostolos Kontzias, Carla M Ward, Neeta S Ogden
(Affiliation: Division of Allergy, Immunology, and Rheumatology, New Jersey Medical School, and Rheumatology Clinic, University Hospital, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ 07103, USA. efthimpv at umdnj.edu)
|
| Journal | Nature clinical practice. Rheumatology
(Nat Clin Pract Rheumatol)
Vol. 3
Issue 6
Pg. 328-35
(Jun 2007)
ISSN: 1745-8382 United States |
| PMID | 17538564
(Publication Type: Journal Article, Review)
|
| Chemical References |
- Adrenal Cortex Hormones
- Antirheumatic Agents
- Cytokines
- Immunosuppressive Agents
|
| Topics |
- Adrenal Cortex Hormones
(therapeutic use)
- Adult
- Antirheumatic Agents
(therapeutic use)
- Cytokines
(drug effects, immunology)
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Still's Disease, Adult-Onset
(drug therapy, physiopathology)
|
