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)

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.

 

 

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]

Created: Nov 23, 2007