A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
XYZ
List of All Topics
Adult Still's Disease
Introduction
Adult Still's disease (ASD) is an inflammatory condition in which you may experience daily spiking fevers, have achy or swollen joints and discover a salmon-pink rash appearing on your body. The disorder is rare. As it progresses, Adult Still's disease may lead to chronic arthritis and other complications.
Still's disease is named after an English doctor named George Still, who described the condition in children in 1896. Still's disease is now known as systemic onset juvenile rheumatoid arthritis (JRA). In 1971, the term "Adult Still's disease" was used to describe adults who had a condition similar to systemic onset JRA. There's no cure for Adult Still's disease; however, treatment may offer symptom relief for Adult Still's disease and help prevent complications.
Signs and symptoms
Most people with Adult Still's disease experience a combination of the following signs and symptoms:
- Fever. You may experience a daily fever of at least 102 F for a week or longer. The fever usually peaks in the late afternoon or early evening. Between episodes, your temperature will likely return to normal.
- Rash. A salmon-pink bumpy or flat rash may come and go with the fever. The rash usually appears on your trunk, arms or legs. Physical contact such as rubbing your skin or exposing it to hot water may provoke the rash to appear.
- Achy and swollen joints. You may find that your joints — especially your knees, wrists, ankles and elbows — are stiff, painful and inflamed. Usually, the joint discomfort lasts at least two weeks.
- Muscle pain. Muscular pain associated with Adult Still's disease usually ebbs and flows with the fever. It may be severe enough to disrupt your daily activities.
- Sore throat.
- Swollen lymph nodes in your neck.
- Enlarged liver or spleen.
Causes
Although it's not certain what causes Adult Still's disease, it may be that the condition is triggered by a viral or bacterial infection.
Treatment
Doctors use a variety of drugs to treat Adult Still's disease. The type of drug you'll take depends on the severity of your symptoms and whether you experience side effects.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, Anaprox, others), help reduce inflammation. These drugs are often useful for controlling mild symptoms. If you take NSAIDs, you'll need regular blood tests to monitor your liver function, because high doses of NSAIDs can damage your liver.
- Glucocorticoids. People with high fever spikes, severe joint symptoms or complications with their internal organs might require glucocorticoids, such as prednisone. Glucocorticoids help subdue your body's immune response. While glucocorticoids are often a successful treatment for Adult Still's disease, these drugs may lower your body's resistance to infections and will increase your risk of developing osteoporosis.
- Methotrexate. The medication methotrexate (Rheumatrex) has been used successfully in a small series of patients to treat ASD. It may also be used as a "steroid-sparing agent," meaning that if you take methotrexate, smaller doses of corticosteroids may be able to control your disease.
Several drugs that are not standard therapy for Adult Still's disease have been reported to help some people with this condition. One of these drugs is called a tumor necrosis factor (TNF) blocker. TNF blockers, including infliximab (Remicade) and etanercept (Enbrel), may work by blocking the activity of TNF, a chemical that causes joint swelling.
Other experimental drugs, including cyclosporine (Sandimmune), intravenous immunoglobulin (IVIg), anakinra (Kineret) and thalidomide (Thalomid), have also been successful in small groups of people.
Outlook
Even with treatment, it's difficult to predict the course of Adult Still's disease. Some people might only experience a single episode, while for others Adult Still's disease may develop into a chronic condition. About one-third of people with the disorder fall into each of the following groups:
- Recovery. In some cases, the signs and symptoms disappear within one year and do not recur.
- Occasional flare-ups. People with this form of the condition experience unpredictable eruptions of their signs and symptoms but feel normal between episodes.
- Chronic arthritis. The chronic form of Adult Still's disease may last for years and cause debilitating arthritis. Fortunately, up to 25 percent of the people with chronic Adult Still's disease eventually improve.
Adult Still's disease can't be prevented. However, sticking to your treatment regimen and calling your doctor if you develop problems may help reduce the risk that you'll suffer complications.
Information obtained from National Institute of Health