Clinical features of elderly-onset Adult-onset Still’s disease
Akihito Maruyama, Ayako Kokuzawa, Yusuke Yamauchi, Yohei Kirino, Hideto Nagai, Yasushi Inoue, Toshiyuki Ota, Yutaka Chifu, Satomi Inokuchi, Syuichi Koarada, Akihide Ohta, Masahiro Iwamoto, Yoshifumi Tada
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.