Serosal involvement in adult-onset Still’s disease: A multicentre and retrospective study

Author:

Li Yixuan1,Guo Ruru1,Li Wenjing2,Feng Jiaqi1,Jin Yuyang1,Li Jia1ORCID,Lu Liangjing1,Feng Xuebing2,Chen Xiaoxiang1ORCID

Affiliation:

1. Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai, China

2. Department of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School , Nanjing, China

Abstract

ABSTRACT Objectives This study evaluated the characteristics of serosal involvement in adult-onset Still’s disease (AOSD). Methods Patients meeting the Yamaguchi classification criteria were classified into AOSD with and without serosal involvement according to their manifestations and sonography/radiography. Clinical data was retrospectively reviewed from 102 patients with AOSD in two centres. Results Forty-two patients (41.2%) had serosal involvement. The frequencies of pulmonary infiltrate and impaired liver function were significantly higher in patients with serosal involvement (p = .002 and p = .007, respectively), who also had a higher modified systemic score (p = .009). In addition, the percentages of CD3+ T cells (p < .001) and, especially, the CD8+ T cells (p = .004) were significantly increased in the peripheral blood of AOSD patients with serosal involvement. Notably, patients with serosal involvement were more likely to develop macrophage activation syndrome (p = .047) and a chronic pattern (p = .016) during the follow-up. Conclusions Patients with serosal involvement demonstrated the more severe disease activity and different immune phenotypes; these patients were more likely to develop macrophage activation syndrome, and they may require more aggressive treatment at an early time to control their systemic inflammation.

Funder

National Natural Science Foundation of China

Publisher

Oxford University Press (OUP)

Subject

Rheumatology

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