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Criteria for Diagnosis of Still's Disease

Yamaguchi criteria for classification of adult Still's disease

Presence of 5 or more criteria, of which at least 2 are Major (96% sensitivity; 92% specificity)

Major Criteria

  • Temperature of >39°C for >1 wk       

  • Leukocytosis >10,000/mm3 with >80% PMNs          

  • Typical rash    

  • Arthralgias >2 wk       

Minor Criteria

  • Sore throat

  • Lymph node enlargement

  • Splenomegaly

  • Liver dysfunction (high AST/ALT)

  • Negative ANA, RF

Cush criteria for classification of adult Still's disease

Requires all of the following:

  • Fever > 39 degrees

  • Arthralgia or arthritis

  • Rheumatoid factor < 1:80

  • ANA < 1:100

In addition to any two of the following:

  • WBC count > 15,000

  • Stills rash

  • Pleuritis or Pericarditis

  • Hepatomegaly, Splenomegaly, or Lymphadenopathy

Abbreviations: ALT, alanine transaminase; ANA, antinuclear antibody; AST, aspartate transminase; PMN, polymorphonuclear leukocyte; RF, rheumatoid factor; WBC, white blood cells.

 

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References:

  1. Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H, Kashiwazaki S, Tanimoto K, Matsumoto Y, Ota T, et al. Preliminary criteria for classification of adult Still's disease. J Rheumatol. 1992 Mar;19(3):424-30. [Medline]

  2. Cush JJ, Medsger TA Jr, Christy WC, Herbert DC, Cooperstein LA. Adult-onset Still's disease. Clinical course and outcome. Arthritis Rheum. 1987 Feb;30(2):186-94. [Medline]

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Created: Nov 23, 2007
Last Modified: 10/24/2010

 
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