@article {Jiangjrheum.100766, author = {Lindi Jiang and Zhen Wang and Xiaomin Dai and Xuejuan Jin}, title = {Evaluation of Clinical Measures and Different Criteria for Diagnosis of Adult-onset Still{\textquoteright}s Disease in a Chinese Population}, elocation-id = {jrheum.100766}, year = {2011}, doi = {10.3899/jrheum.100766}, publisher = {The Journal of Rheumatology}, abstract = {Objective To determine the value of clinical measures in diagnosis of adult-onset Still{\textquoteright}s disease (AOSD), and to identify the optimal set of proposed classification criteria, in a Chinese population. Methods A total of 70 patients with AOSD and 140 non-AOSD inpatients with fever were retrospectively identified at Zhongshan Hospital, Shanghai, from January 2003 to December 2009. Clinical measures and 4 sets of diagnostic criteria (Yamaguchi, Calabro, Cush, and Reginato) were evaluated by sensitivity, specificity, positive/negative predictive value (PPV, NPV), and positive/negative likelihood ratio (PLR, NLR) for diagnosis of AOSD. Results In our series, higher sensitivity included hyperpyrexia (temperature >= 39{\textdegree}C, 94.29\%), arthralgia (80.0\%), polymorphonuclear neutrophils (PMN) >= 75\% (84.29\%), serum ferritin >= 2-fold the upper normal value (90.0\%), negative antinuclear antibodies (85.29\%), and rheumatoid factor (84.38\%); while higher specificity included transient erythema (98.57\%), sore throat (85.0\%), leukocytes >= 15,000/mm3 (87.86\%), and PMN >= 85\% (85.0\%). Rash, arthralgia, and sore throat were found to have better sensitivity and specificity (PLR 3.29{\textendash}4.86). Leukocytes >= 10,000/mm3, PMN >= 80\%, and serum ferritin >= 5-fold the upper normal limit were set as critical points. The Reginato criteria set had the highest specificity, 99.29\%. The Yamaguchi set had the highest sensitivity, 78.57\%, with a better accuracy of 87.14\%. Conclusion The Yamaguchi diagnostic criteria had better accuracy in Chinese patients. Indicators such as rash, arthralgia, sore throat, leukocytes >= 10,000/mm3, PMN >= 80\%, and serum ferritin >= 5-fold the upper normal limit were helpful for diagnosis of AOSD. We recommend using these indicators in combination instead of alone.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/early/2011/01/27/jrheum.100766}, eprint = {https://www.jrheum.org/content/early/2011/01/27/jrheum.100766.full.pdf}, journal = {The Journal of Rheumatology} }