2021 Volume 33 Issue 1 Pages 62-69
Background: The mean age at onset of adult-onset Still’s disease（AOSD）is increasing in Japan. However, the clinical differences between elderly-onset Still’s disease（EOSD）patients（age ≥ 65 years old）and younger-onset Still’s disease（YOSD）patients are yet to be sufficiently investigated.
Objectives and Methods: To report a severe case of EOSD and to examine the clinical features of EOSD patients.
Results: An 84-year-old woman was admitted to our hospital for spike fever, rash and sore throat for which antibiotics were ineffective. Multiple lymphadenopathies, splenomegaly and hyperferritinemia were observed, and she was diagnosed AOSD after excluding infectious and malignant diseases. Her symptoms were refractory to intravenous methylprednisolone pulse and high dose glucocorticoid therapies, but remission was obtained with a combination of cyclosporine A and intravenous cyclophosphamide.
In our hospital, 38 patients with a diagnosis of AOSD（YOSD: 22, EOSD: 16, mean age at onset: 52.0 ± 22.2 years old）were admitted between January 2001 and September 2019. The proportion of female patients in the EOSD group（93.8%）was significantly higher than that of in the YOSD group（59.1%）（p < 0.05）. There were no significant differences in mortality rate, remission rate or relapse rate between those two groups, but comorbidities including infections and cardiovascular diseases, and venous thromboses were more frequent in EOSD patients.
Conclusion: The clinical features of EOSD patients was analyzed in a single center analysis. Further investigations are required for confirming the clinical features of EOSD patients.
