The risk of relapse for adult-onset Still’s disease: A retrospective study of 56 patients

Objective: Adult-onset Still’s disease (AOSD) is a multisystem autoinflammatory disorder characterized by a high spiking fever, arthralgia or arthritis, skin rash, leukocytosis, and hyperferritinemia. The relapse rate is high, from 40% to 50%. Our objective was to retrospectively analyze the risk of relapse for AOSD. Methods: Retrospective data of patients diagnosed with AOSD in our institute during 2013-2018 were analyzed. The diagnoses were based on the Yamaguchi criteria for AOSD. All long-term follow-up data were collected from medical records and phone calls. Results: In total, 56 patients with AOSD were included in this study. The mean age of the patients was 39.2 ± 14.2 years, and 37 patients (66.1%) were female. Twenty-three patients (41.1%) had experienced at least one relapse of AOSD. The factors associated with relapse were increased levels of lactic dehydrogenase (LDH) (OR = 1.003, P = 0.044) and creatine kinase-myocardial band (CK-MB) (OR = 1.111, P = 0.032). Conclusion: AOSD patients with elevated serum levels of LDH and CK-MB were more likely to have relapses, these prognostic factors may be helpful for the clinical management of AOSD patients.