Via practica 3/2012

Absence of arthritis as a sign of sine syndrome Still's disease in adulthood

The authors highlight the atypical course of Still’s disease in adulthood. It is a sine syndrome (in patient were not alterations of skin, itchy linear urticarial rash or other cutaneous findings, periorbital swelling and erythema of eyelid, organ manifestations), arthritis, occurring after 23 years of the disease in the form of monoarthritis of the right knee. The most notable were present five febrile atacks with chills associated with high inflammatory activity. Treatment with glucocorticoids, cyclosporine and methotrexate suppressed and limited relapse of the disease. An attempt to withdraw basal therapy led to the last relapse of the disease. It is considered the differential diagnostic procedure in nosographic limitations of Still’s disease in adulthood associated with sine syndrome and the treatment of diseases using biologic agents in the future.

Keywords: Still's disease in adulthood, sine syndrome, differential diagnosis, treatment.