Serosal involvement in adult-onset Still’s disease: A multicentre and retrospective study.

This article focuses on the clinical characteristics, immunologic features, treatments, and outcomes of serosal involvement in adult-onset Still's disease (AOSD), a systemic autoinflammatory disorder. In a retrospective multicentre study of 102 AOSD patients diagnosed by the Yamaguchi criteria, 41.2% exhibited serosal involvement (pleurisy and/or pericarditis), which was associated with more severe disease activity, including higher frequencies of pulmonary infiltrates, impaired liver function, and increased risk of macrophage activation syndrome (MAS). Immunologically, patients with serosal involvement showed elevated percentages of CD3+ and CD8+ T cells and decreased natural killer cells. These patients required more aggressive treatment, including higher doses of glucocorticoids and immunosuppressants, and had a greater likelihood of developing a chronic disease pattern. The study suggests that serosal involvement indicates more severe systemic inflammation in AOSD and highlights the need for tailored scoring models and early intensive therapy.