Adult-onset Still's disease laboratory findings

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Adult-onset Still's disease

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Adult-onset Still's disease (AOSD) is diagnosed based on clinical presentation and history findings. However, due to underlying inflammatory process, inflammatory marker such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) may be elevated. Complete blood count may show leukocytosis with a left shift (increased neutrophils), anemia thrombocytosis or pancytopenia (in cases of hemophagocytic syndrome).

Laboratory Findings

Adult-onset Still's disease (AOSD) is diagnosed based on clinical presentation and history findings. However, due to underlying inflammatory process, the following laboratory abnormalities may be observed:

Inflammatory markers

  • Increased ferritin (greater than 5 times of upper limit of normal may aid in diagnosis- > 1000 ng/ml)
  • Elevated ESR
  • Elevated CRP

Complete blood count

  • Leukocytosis with pre-dominant neutrophils (left shift)
  • Anemia
  • Thrombocytosis
  • Pancytopenia (in case of hemophagocytic syndrome)

Partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT)

  • Increased in case of disseminated intravascular coagulation (DIC)

Liver function tests (LFTs)

  • Increased lactic dehydrogenase
  • Increased aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
  • Increased γ‐glutamyltransferase
  • Increased bilirubin

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