Adult onset Stills disease in a tertiary care hospital of Pakistan.

Objective: To study the clinical characteristics of Stills disease in a tertiary care hospital of Pakistan and compare it with similar published studies.

Materials And Methods: (Retrospective descriptive study) Thirteen patients with Adult onset stills disease were identified by chart review of last ten years from 1995 to 2005 at Aga Khan University Hospital (AKU), a tertiary care private medical university in Karachi Pakistan. Demographic and other specific information was recorded on standardized data sheet and analyzed by SPSS 11.5 software.

Results: Mean age of patients was 26.54 +/- 10.34 years, of which 8 (61.5%) were males. The most common presenting features were fever (100%), arthralgias and myalgias (100%) with large joint involvement (91.7%), significant weight loss (30.8%), sore throat (53.8%). None of the patients had skin rashes with fever, chest and abdominal pains. One patient had cervical lymph node swelling and 4 (33.3%) patients had splenomegally. The common laboratory findings were: leukocytosis and anaemia (100%), elevated ESR and C reactive protein (100%). Thrombocytosis (56.2%) and elevated Liver function tests (62%). Seven patients had serum ferritin checked which was in the range of 1872 to 16652 iu/l. None of the patients had positive ANA, Anti-DNA or RA factor. Twelve patients had a chest x-ray done, among them 11 were normal, one had pleural effusion. The clinical course of the patients who were followed for three months, was monocyclic (53.8%), polycyclic (30.8%) and persistent (15.4%).

Conclusion: Clinical characteristics of Stills disease in our country are mostly similar to those seen in other regions, suggesting that same pathogenetic factors may be implicated in patients from different genetic back grounds and geographic locations.