Criteria

Yamaguchi classification criteria for AOSD[48]

At least five criteria are required to confirm a clinical diagnosis of AOSD, two or more of which must be major criteria AND any infection, malignancy, or other rheumatic disorder known to mimic AOSD must be excluded.

Major criteria

  • Fever of at least 39.0°C (102.2°F) lasting at least 1 week

  • Arthralgias or arthritis lasting 2 weeks or longer

  • A non-pruritic macular or maculopapular skin rash that is salmon-coloured in appearance and usually found over the trunk or extremities during febrile episodes

  • Leukocytosis (10,000/microlitre or greater), with at least 80% granulocytes

Minor criteria

  • Sore throat

  • Lymphadenopathy

  • Hepatomegaly or splenomegaly

  • Abnormal liver function studies, particularly elevations in aspartate and alanine aminotransferase and lactate dehydrogenase concentrations

  • Negative tests for antinuclear antibody (ANA) and rheumatoid factor (RF).

Fautrel classification criteria for AOSD[49]

The Fautrel criteria were developed to avoid the need for exclusion criteria but require testing of glycosylated ferritin, which is not available in many healthcare facilities. A confirmation of an AOSD diagnosis requires:

  • ≥4 major criteria OR

  • three major criteria AND two minor criteria

Major criteria

  • Spiking fever ≥39.0°C (≥102.2°F)

  • Arthralgias

  • Transient erythematous rash

  • Pharyngitis

  • Polymorphonuclear neutrophils ≥80%

  • Glycosylated ferritin ≤20%

Minor criteria

  • Maculopapular rash

  • Leukocytes ≥10,000/microlitre (10 × 10⁹/L)

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