Adult Still’s Disease

Adult-onset Still’s disease is a rare type of arthritis that is thought to be autoummune or autoinflammatory. It has similar symptoms to systemic-onset juvenile idiopathic arthritis -- fever, rash and joint pain. It begins in adulthood, so it's compared to rheumatoid arthritis. Inflammation may affect a few joints at first. Over time, more joints may be involved. Some people may have only one bout of the illness followed by lasting remission (no visible symptoms), while others develop chronic arthritis. The disease affects men and women equally, usually young adults between the ages of 16 and 35. 
 

The cause of adult Still’s disease is unknown. Research suggests that it may be triggered by an infection.

Symptoms usually begin with a high fever that spikes once or twice a day and a salmon-pink rash on the trunk, arms or legs. Other symptoms include sore throat and swollen lymph nodes in the neck. 

A few weeks after these initial symptoms, joints and muscles begin aching. These aches last at least two weeks. The most commonly affected joints are the knee and wrist. The ankles, shoulders, elbows and finger joints may also be involved.

Diagnosis is based on review of symptoms, medical history, physical examination and possibly laboratory tests.  There is no single test that can diagnose adult Still’s disease. Instead, blood tests are used to rule out other diseases with similar symptoms. Other tests, such as X-rays, may be done to check for joint inflammation or damage.

Doctors use several drugs to treat adult Still's disease. Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) help to reduce mild pain and inflammation. Corticosteroids, such as prednisone, are needed if the disease is severe or doesn't respond to prescription NSAIDs. Disease-modifying drugs (DMARDs), such as methotrexate, and biologics, are needed in more severe cases or if the arthritis becomes chronic. It may be necessary to take more than one medication at a time to control symptoms. 

With adult Still’s disease, the medications may need to be taken even after symptoms go away. This is called maintenance therapy. It’s important to keep inflammation under control to prevent damage to joints and organs.

Caring for the body and mind are key components of an adult Still's disease management plan. Make positive and healthy lifestyle choices and acknowledge the physical and emotional effects of arthritis. Proper nutrition, activity, rest and following doctors' orders are important for managing the condition and possible medication side-effects.