Adult-onset Still's disease laboratory findings

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: Syed Hassan A. Kazmi BSc, MD [2]

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