Yamaguchi criteria for classification of adult Still's disease

Presence of 5 or more criteria, of which at least 2 are Major (96% sensitivity; 92% specificity)

Major Criteria

• Temperature of >39°C for >1 wk       

• Leukocytosis >10,000/mm3 with >80% PMNs          

• Typical rash    

• Arthralgias >2 wk       

Minor Criteria

• Sore throat

• Lymph node enlargement

• Splenomegaly

• Liver dysfunction (high AST/ALT)

• Negative ANA, RF

Cush criteria for classification of adult Still's disease

Requires all of the following:

• Fever > 39 degrees

• Arthralgia or arthritis

• Rheumatoid factor < 1:80

• ANA < 1:100

In addition to any two of the following:

• WBC count > 15,000

• Stills rash

• Pleuritis or Pericarditis

• Hepatomegaly, Splenomegaly, or Lymphadenopathy

Abbreviations: ALT, alanine transaminase; ANA, antinuclear antibody; AST, aspartate transminase; PMN, polymorphonuclear leukocyte; RF, rheumatoid factor; WBC, white blood cells.

 

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References:

1. Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H, Kashiwazaki S, Tanimoto K, Matsumoto Y, Ota T, et al. Preliminary criteria for classification of adult Still's disease. J Rheumatol. 1992 Mar;19(3):424-30. [Medline]

2. Cush JJ, Medsger TA Jr, Christy WC, Herbert DC, Cooperstein LA. Adult-onset Still's disease. Clinical course and outcome. Arthritis Rheum. 1987 Feb;30(2):186-94. [Medline]

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