How can adult still's disease be completely cured?

summary

Adult still's disease is a group of clinical syndrome with unknown etiology, such as flaccid fever, transient pleomorphic rash, arthritis or arthralgia, enlargement of liver, spleen and lymph nodes, and peripheral leukocytosis. It is called adult still's disease. In the past, it was named as hyposepsis and allergic hyposepsis. The disease is more common in young people, 18mdash; At the age of 25, the morbidity rate of male and female was almost the same. How can adult still's disease be completely cured?

How can adult still's disease be completely cured?

The etiology and pathogenesis are still uncertain. According to the hemolytic streptococcus cultivated from the alveolar of many patients, the incidence of some patients is related to vaccination, pollen, dust or food allergy. Clinically, it often invades the joint and serous tissue, presents the process of acute inflammation, has the performance of systemic involvement and immune abnormalities, antibiotics are ineffective and renal corticosteroids are effective, so it is considered to be an infectious allergy. Infection plays a role in the acute stage, while allergy plays a role in the whole course.

Glucocorticoid: prednisone 1mg / (kg? D), gradually reduced after symptoms improved, the total course of treatment should not exceed 6 months. Non steroidal drugs can be added in the process of reduction to consolidate the curative effect. When the curative effect is not good, high dose methylprednisolone pulse therapy can be used. NSAIDs can be used alone in mild cases, such as naproxen 0.2g, twice a day, indomethacin 25mg, three times a day, and voltalin 25-60mg, three times a day.

The X-ray findings of the disease are nonspecific. In the early stage, soft tissue swelling and osteoporosis near the joint can be seen. In the recurrent or persistent arthritis, articular cartilage destruction and bone erosion can be seen. Slow acting anti rheumatic drugs: long term poor control of the disease, glucocorticoid efficacy is not good, can choose the following drugs. Methotrexate, rhodamine, penicillamine, sulfasalazine and Tripterygium wilfordii polyglycoside, the dosage of which can be seen in the treatment of rheumatoid arthritis.

matters needing attention

The prominent manifestation of this disease is that the total number of white blood cells in patients with peripheral blood increased, generally in 14 × 10/L～20 × 10 / L, there are also reports as high as 50 × 10 / L, leukemoid reaction. Neutrophils were the main type of leukocytosis, and the classification was generally above 0.9. Neutrophil nuclei moved to the left, but eosinophils did not disappear. More than half of the patients had a platelet count of 300 × Above 10 / L\ ESR increased significantly and CRP increased slightly or moderately. Serum ferritin increased more than 10 times higher than the normal level in the active stage of the disease, and paralleled with the disease activity. Creatine phosphatase and lactate dehydrogenase increased in patients with myositis\ The myelogram was characterized by infection, active granulocyte proliferation, left shift of nucleus, toxic granules and vacuolar degeneration in cytoplasm. Bone marrow culture was negative.