What is Adult Still's Disease?

Angela, 37, was glad to finally get a diagnosis of adult Still's disease after months of strange symptoms. However, she was shocked to find that she was the one individual out of 100,000 to contract this disorder.

What is Adult Still's Disease?

Experts also refer to it as adult-onset Still's disease, according to MedlinePlus. This is an unusual and progressive inflammatory condition that can result in chronic arthritis and other complications.

The Mayo Clinic indicates that the disease takes its name for George Still, an English physician who described the condition in children in 1896. Systemic onset is the type of juvenile rheumatoid arthritis also known as Still's disease in children. It's much more prevalent than the adult disorder.

Doctors remain unsure of any causes of adult Still's disease, though researchers suspect that a viral or bacterial infection might trigger it. The illness peaks twice: between 15 to 25 years of age and between 36 and 46. Researchers believe the disorder probably doesn't have a genetic basis since multiple cases seldom occur in families.

Symptoms and Complications

Doctors associate four principal symptoms with adult Still's disease:

Fever. It usually occurs daily for a week or longer and reaches at least 102 degrees F. Some patients experience two fever spikes a day and a normal temperature between them.

Rash. The salmon pink rash might be flat or bumpy. It accompanies the fever and occurs on the trunk, arms or legs. Pressure against the skin can trigger the rash.

Aching and swollen joints. Those most likely to be affected include the knees, ankles, shoulders, wrists, hands and elbows. They become stiff and painful due to inflammation.

Muscle pain. It usually follows the pattern of any fever. It can be so severe that it totally disrupts an individual's normal activities.

Although less common, certain other symptoms can strike individuals with adult Still's disease. Among them are a sore throat, swollen lymph nodes in the neck and an enlarged liver or spleen.

The potential complications from the disorder are all linked to chronic inflammation of joints and other tissues. The most likely are joint destruction, heart inflammation and excess fluid around the lungs.

Diagnosis and Treatment

Any diagnosis of adult Still's disease starts with a physical exam and surveying the patient's symptoms. Doctors also use imaging tests like X-rays, CT scans and ultrasound to check for the anatomical changes associated with the disorder. A number of blood tests point toward the possibility of the condition.

While there is no cure for this illness, doctors use a number of methods to treat it:

Nonsteroidal anti-inflammatory drugs (NSAIDs). Typical brands include Advil, Motrin and Aleve. They're used for mild symptoms and help reduce inflammation.

Glucocorticoids. They're a type of steroid and help tame the response of an individual's immune system. The most common is prednisone. They're useful for patients with high-fever spikes, complications involving their internal organs or severe joint problems. However, prolonged usage can reduce the ability to resist infections while raising the risk of osteoporosis.

Methotrexate. Pharmacies sell it under the brand name Rheumatrex. It works as a steroid-sparing drug and has helped a small percentage of patients with adult Still's disease.

Biologic response modifiers. These drugs block the effect of tumor necrosis factor (TNF), which is a specific cell in the immune system associated with inflammation. Brand names include Remicade, Humira and Enbrel. This type of medication isn't standard treatment for the disorder. Experts aren't sure whether TNF blockers can control adult Still's disease over an extended period.

This condition is unpredictable. While some patients experience a single episode of adult Still's disease, others suffer from chronic illness. Some individuals find their symptoms disappear within a year and never return. Others experience flare-ups from time to time, while about a third develop debilitating arthritis. It's important for a patient to perform a workout approved by his or her doctor in order to maintain a range of motion and achieve relief from pain and stiffness.

Sources:

http://www.nlm.nih.gov/medlineplus/ency/article/000450.htm

http://www.mayoclinic.com/health/adult-stills-disease/DS00792