Erişkin Başlangıçlı Still Hastalığının Diğer Nedeni Bilinmeyen Ateş Sebeplerinden Ayrımını Sağlayabilecek Klinik ve Laboratuvar Parametrelerinin Araştırılması

Abstract

The aim of this study is to determine the possible clinical and laboratory parameters to distinguish adult-onset Still's disease (AOSD) and other causes of fever of unknown origin (FUO). Patients with FUO who admitted to Hacettepe University Hospitals, inpatient departments of internal medicine and patients with AOSD who were primarly followed up by Hacettepe University Department of Rheumatology were recruited to study. Pre-determined clinical and laboratory data were recorded in all patients. Prospectively collected data were evaluated with appropriate statistical methods. Odds ratios were obtained by logistic regression analysis. As a result of the analyzes, arthralgia (Odds ratio (OR), 158,1, confidence interval CI, 4,5-5755, p = 0,006), rash (OR, 31,3; CI, 3,6-271,9; p = 0,002 ), sore throat (OR, 20,8; CI, 2,8-154,7, p = 0,003), neutrophilia (OR, 18,4; CI, 2,6-132,3; p = 0.004), serum ferritin level higher than 5 times or more upper limit (OR, 132,8; CI, 7,1-2502,9 ; p = 0,001 ) and elevated lactate dehydrogenase levels ( OR, 6,2; CI, 0,76-50,9 ; p = 0,087 ) were associated with the likelihood of diagnosing AOSD, on the other hand, number of daily fever peaks equal or greater then 3 ( OR, 69; CI, 2,2-2114,4 ; p = 0,015 ) was associated with the unlikelihood of diagnosing AOSD. The presence of clinical and/or laboratory parameters listed above may guide clinicians in the differential diagnosis of FUO, which is one of the most difficult diagnostic challanges in clinical practice.