ISSN 2412-4036 (print)
ISSN 2713-1823 (online)

Still’s disease of adults in infectious diseases clinical picture (clinical observation)

Chernysheva O.O., Fedkina Yu.A., Timchenko O.L.

1) Russian University of Medicine of the Ministry of Healthcare of Russia, Moscow; 2) Infectious Diseases Clinical Hospital No. 2 of the Department of Healthcare of Moscow
Abstract. Article presents a clinical case of Still’s disease arising in adults, diagnosed using the modified Yamaguchi criteria. Differential diagnostic search in a female patient admitted to an infectious diseases hospital with a diagnosis of fever of unknown etiology is described in details.

Keywords

fever of unknown origin
Still’s disease of adults
Yamaguchi criteria

References

1. Wright WF, Auwaerter PG. Fever and fever of unknown origin: Review, recent advances, and lingering dogma. Open Forum Infect Dis. 2020;7(5):ofaa132.

PMID: 32462043. PMCID: PMC7237822. https://doi.org/10.1093/ofid/ofaa132

2. (Grebenyuk V, Krystufkova O, Gregova M, Sokalska-Jurkiewicz M, Steinbauerova R, Sukovska M et al. Fever of unknown origin. VnitrLek. 2021;67(1):32–42 (In Czech)). PMID: 33752399.

3. Szymanski AM, Clifford H, Ronis T. Fever of unknown origin: A retrospective review of pediatric patients from an urban, tertiary care center in Washington, DC. World J Pediatr. 2020;16(2):177–84.

PMID: 30888665. https://doi.org/10.1007/s12519-019-00237-3

4. Erdem H, Baymakova M, Alkan S, Letaief A, Yahia WB, Dayyab F et al. Classical fever of unknown origin in 21 countries with different economic development: An international ID-IRI study. Eur J ClinMicrobiol Infect Dis. 2023;42(4):387–98.

PMID: 36790531. PMCID: PMC9930069. https://doi.org/10.1007/s10096-023-04561-5

5. Zhao M, Wu D, Shen M. Adult-onset Still’s disease with neurological involvement: A single-centre report. Rheumatology (Oxford). 2021;60(9):4152–57.

PMID: 33369675. https://doi.org/10.1093/rheumatology/keaa899

6. Kadavath S, Efthimiou P. Adult-onset Still’s disease – pathogenesis, clinical manifestations, and new treatment options. Ann Med. 2015;47(1):6–14.

PMID: 25613167. https://doi.org/10.3109/07853890.2014.971052

7. Efthimiou P, Kontzias A, Hur P, Rodha K, Ramakrishna GS, Nakasato P. Adult-onset Still’s disease in focus: Clinical manifestations, diagnosis, treatment, and unmet needs in the era of targeted therapies. Semin Arthritis Rheum. 2021;51(4):858–74.

PMID: 34175791. https://doi.org/10.1016/j.semarthrit.2021.06.004

8. Owlia MB, Mehrpoor G. Adult-onset Still’s disease: A review. Indian J Med Sci. 2009;63(5):207–21.

PMID: 19584494. https://doi.org/10.4103/0019-5359.53169

9. Российское научное медицинское общество терапевтов. Мазуров В.И., Трофимов Е.А., Гайдукова И.З. Болезнь Стилла взрослых. Основы диагностики и лечения. Методические указания для врачей общей практики, терапевтов, врачей-ревматологов. Доступ: https://www.rnmot.ru/public/uploads/RNMOT/clinical/2022/Карманная%20версия%20РНМОТ.pdf (дата обращения – 19.10.2025). (Russian Scientific Medical Society of Internal Medicine. Mazurov VI, Trofimov EA, Gaydukova IZ. Adult Still’s disease. Fundamentals of diagnosis and treatment. Guidelines for general practitioners, therapists, rheumatologists. URL: https://www.rnmot.ru/public/uploads/RNMOT/clinical/2022/Карманная%20версия%20РНМОТ.pdf (date of access – 19.10.2025) (In Russ.)).

10. Feist E, Mitrovic S, Fautrel B. Mechanisms, biomarkers and targets for adult-onset Still’s disease. Nat Rev Rheumatol. 2018;14(10):603–18.

PMID: 30218025. PMCID: PMC7097309. https://doi.org/10.1038/s41584-018-0081-x

11. Mimura T, Kondo Y, Ohta A, Iwamoto M, Ota A, Okamoto N et al. Evidence-based clinical practice guideline for adult Still’s disease. Mod Rheumatol. 2018;28(5):736–57.

PMID: 29651907. https://doi.org/10.1080/14397595.2018.1465633

12. Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H et al. Preliminary criteria for classification of adult Still’s disease. J Rheumatol. 1992;19(3):424–30.

PMID: 1578458.

13. Sfriso P, Bindoli S, Doria A, Feist E, Galozzi P. Canakinumab for the treatment of adult-onset Still’s disease. Expert Rev Clin Immunol. 2020;16(2):129–38.

PMID: 31957508. https://doi.org/10.1080/1744666X.2019.1707664

14. Gillard L, Pouchot J, Cohen-Aubart F, Kone-Paut I, Mouterde G, Michaud M et al. JAK inhibitors in difficult-to-treat adult-onset Still’s disease and systemic-onset juvenile idiopathic arthritis. Rheumatology (Oxford). 2023;62(4):1594–604.

PMID: 35920788. https://doi.org/10.1093/rheumatology/keac440

15. Ruscitti P, Cantarini L, Nigrovic PA, McGonagle D, Giacomelli R. Recent advances and evolving concepts in Still’s disease. Nat Rev Rheumatol. 2024;20(2):116–32.

PMID: 38212542. https://doi.org/10.1038/s41584-023-01065-6

16. Santos M, Rodrigues D, Santos H, Parente C, Carvalho C, Rufino R et al. Neurological manifestations of adult-onset Still’s disease-case-based review. ClinRheumatol. 2021;40(1):407–11.

PMID: 32648101. https://doi.org/10.1007/s10067-020-05244-8

About the Authors

Olga O. Chernysheva, MD, postgraduate student of the Department of infectious diseases and epidemiology, N.A. Semashko Scientific and Educational Institute of Clinical Medicine, Russian University of Medicine of the Ministry of Healthcare of Russia, infectious disease physician of Infectious Diseases Clinical Hospital No. 2 of the Department of Healthcare of Moscow. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: chernishevaoo@mail.ru
ORCID: https://orcid.org/0000-0003-4712-1240
Yulia A. Fedkina, MD, PhD (Medicine), assistant professor of the Department of infectious diseases and epidemiology, N.A. Semashko Scientific and Educational Institute of Clinical Medicine, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
Email: yulija05@mail.ru
ORCID: https://orcid.org/0000-0002-7040-7768
Olga L. Timchenko, MD, Dr. Sci. (Medicine), associate professor, professor of the Department of infectious diseases and epidemiology, N.A. Semashko Scientific and Educational Institute of Clinical Medicine, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
Email: otimchenko@mail.ru
ORCID: https://orcid.org/0000-0002-1596-2216

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