[Still's disease in sub-Saharan Africa through ten observations from the internal medicine department of Libreville University Hospital (Gabon)].

INTRODUCTION

Introduction. Still's Disease (SD) is a rare systemic inflammatory disorder that is most common in children. In the adult form, it can be primary or the resurgence of an infantile form. We report 10 observations of Still's disease in the Gabonese population, with the aim of confirming its existence in this country an studying its specific features.

MATERIAL AND

METHODS

This was a retrospective, descriptive and analytical study carried out in the Internal Medicine Department of the CHU of Libreville from 1.12.2003 to 31.12.2021, using the records of patients hospitalized in this department and/or followed up on an outpatient basis. The selected patients fulfilled the Yamaguchi and Fautrel criteria. Epidemiologic, socioeconomic, clinical, biological, morphologic, immunologic, therapeutic, evolutionary and seasonal data were detailed.

RESULTS

Ten patients (4 men and 6 women), mostly students with a mean age of 22 years, were included. The time to diagnosis of SD was 31.3 months, with fever in 100% of cases, joint and skin involvement in 80%, and ENT involvement in 70%. An inflammatory syndrome, predominantly neutrophilic hyperleukocytosis, hepatic signs, and hyperferritinemia coexisted with an immunologic work-up that was always negative. Corticosteroid therapy (n=10) combined with per os methotrexate from the beginning (n=1) or in cases of corticoresistance (n=4) was the rule. One patient died and one was lost to follow-up.

DISCUSSION AND

CONCLUSION

The clinical and biological presentation of SD is comparable to that of the Caucasian population. However, our study confirms in the low incidence of liver, lymph node and heart damage, which needs to be confirmed by other studies in a larger cohort. The high cost of this disease, which is a diagnosis of exclusion, may partly explain the difficulties in diagnosing SD.