๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Still disease
Still disease
Only few authors have reported the histologic findings following reaction to coelenterate stings. Non-specific perivascular inflammation with lymphocytes and variable numbers of eosinophils appear to be characteristic. Some cases show dense, sheetlike aggregates of lymphocytes, and histiocytes.16 Variable dermal edema may be an additional feature. Spongiosis and vesicle formation are also sometimes described.16โ18 One fatal case showed only vascular congestion without significant inflammation, a histologic picture that likely reflects the fact that the patient died only 40 minutes after being stung.6 Only occasionally are nematocyst capsules and tubes identified.6,18
Differential diagnosis The histologic differential diagnosis of reactions to coelenterates includes other hypersensitivity reactions. Short of finding nematocysts, the diagnosis depends entirely on clinical correlation.
Clinical features Juvenile rheumatoid arthritis or systemic juvenile idiopathic arthritis (Still disease) is a heterogeneous group of disorders which share in common an inflammatory arthritis with many features similar to rheumatoid arthritis in adults. Juvenile rheumatoid arthritis patients, however, are seronegative for rheumatoid factor.1 There are marked differences in prevalence from region to region. Whites in Europe, the United States, and Australia (4 per 1000) have the highest prevalence.2,3 One study has suggested that the incidence of the disease is decreasing.4 This same study also documented incidence peaks indicating a possible cyclical pattern.4 Other studies have found seasonal variation in certain regions such as the Canadian prairies.5 However, such seasonal onset has not been apparent in other areas of Canada, in Denmark, or in Japan.5โ8