Objective To explore the clinical effect and safety of glucocorticoid combined with gamma globulin in the treatment of refractory adult-onset still′s disease (AOSD).Methods Thirty patients with refractory AOSD admitted to the Department of Rheumatology and Immunology of Huainan First People′s Hospital from January 2019 to August 2021 were studied. All were treated with methylprednisolone 2 mg·kg?1·d?1 combined with gamma globulin 400 mg·kg?1·d?1×5 d. The clinical therapeutic effect was observed by clinical manifestations and laboratory indexes. Results Among the 30 refractory AODS patients treated, the body temperature of 4 cases returned to normal after the first day of treatment, the body temperature of 6 cases returned to normal after the second day of treatment, thebody temperature of 14 cases returned to normal after the third day of treatment,the body temperature of 4 cases returned to normal afterthe fourth day of treatment, after 5 days of treatment,the body temperature of all patients returned to normal,the rash subsided,and theswelling and pain of the patients were relieved,and the sore throat was improved,and the enlargement of lymph nodes and spleen was significantly reduced. Compared with before treatment,the clinical manifestation disappeared after 2 months of treatment,the condition remained in remission after 6 months. ESR [(108±26) mm/h vs. (21±8) mm/h, (12±3) mm/h, F=181.03, P<0.05], CRP [(136±46) mg/L vs. (7.0±2.4) mg/L, (3.0±1.2) mg/L, F=180.86, P<0.05], SF [(3 230±1 420) μg/L vs. (320±156)μg/L, (160±46) μg/L, F=91.46, P<0.05], WBC [(18.2±4.9)×109/L vs. (8.2±1.7)×109/L, (5.9±1.2)×109/L, F=81.92, P<0.05] were improved significantly. The laboratory tests continued to improve at the 2nd week, the 1st month, the 2nd month, the 3rd month and the 6th month. No adverse reactions occurred during treatment.Conclusion Gamma globulin can rapidly improve the clinical symptoms and laboratory indexes of refractory adult-onset still′s disease, and it has significant clinical therapeutic effect, low recurrence rate, and is beneficial to glucocorticoid reduction, the disease remains stable after reduction, and is beneficial to avoid the risk of infection after high-dose glucocorticoid therapy. |