A Family Study in Still's Disease

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Abstract
The siblings, parents, and grandparents of a series of 93 patients with Still''s disease were examined clinically and radiologically and their serum was submitted to the sheep cell agglutination test. Of the 304 relatives living within 15 miles of the Canadian Red Cross Memorial Hospital, Taplow, and within 10 miles of Hammersmith Hospital, 277 were examined. These were compared with random population samples examined in the same way in Leigh and Wensleydale. Clinical evidence of definite inflammatory polyarthritis was found in nine of 120 male relatives and in thirteen of the 157 female relatives, the expected numbers being four males and eight females. Of the nine males with polyarthritis, four were diagnosed as cases of spondylitis and one of gout. The remaining males and all the females were diagnosed as cases of rheumatoid arthritis. Radiological evidence of erosive arthritis in the hands was found four times as frequently in the female relatives as in a control group of females of identical age distribution. Sacro-iliitis was three times as common in the male relatives as in the controls. A positive S.C.A.T. was found less often in the relatives than in the random sample. A double inheritance associated with spondylitis and sero-negative peripheral arthritis might perhaps account for these findings.