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http://www.nlm.nih.gov/medlineplus/ency/article/000450.htm
Causes
Fewer than 1 out of 100,000 people develop adult Still's disease each year. It affects women more often than men. Still's disease that occurs in children is called systemic juvenile idiopathic arthritis. The cause of adult Still's disease is unknown. No risk factors for the disease have been identified.
Symptoms
Almost all people with the disease will have fever, joint pain, sore throat, and a rash. Joint pain, warmth, and swelling are common. Most often, several joints are involved at the same time. Often, patients have morning stiffness of joints that lasts for several hours. The fever comes on quickly once per day, most commonly in the afternoon or evening. The skin rash is often salmon-pink colored and comes and goes with the fever. Additional symptoms include: Abdominal pain and swelling Pain with a deep breath (pleurisy) Sore throat Swollen lymph nodes (glands) Weight loss The spleen or liver may become swollen. Lung and heart inflammation may also occur.
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Liver function tests will show high levels of AST and ALT. Rheumatoid factor and ANA test will be negative. Other tests may be needed to check for inflammation of the joints, chest, liver, and spleen: Abdominal ultrasound CT scan of the abdomen X-rays of the joints, chest, or stomach area (abdomen)
Treatment
The goal of treatment for adult Still's disease is to control the symptoms of arthritis. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are usually used first. Prednisone may be used for more severe cases. If the disease persists for a long time (becomes chronic), medicines that suppress the immune system might be needed. Such medicines include: Anakinra (interleukin-1 receptor agonist) Methotrexate Tumor necrosis factor (TNF) antagonists such as Enbrel (etanercept)
Outlook (Prognosis)
Studies show that in about 1 in 5 people all symptoms go away in a year and never come back. In many people, symptoms go away but then come back several times over the next few years. Symptoms continue for a long time (chronic) in about half of patients with adult Still's disease.
Possible Complications
Arthritis in several joints Liver disease Pericarditis Pleural effusion Spleen enlargement
Alternative Names
Still's disease - adult; AOSD
References
Lee LA, Werth VP. The Skin and Rheumatic Diseases. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2012:chap 43. Clarke JT. Other Rheumatologic Diseases. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds. Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 45. Pay S, Turkcapar N, Kalyoncu M, et al. A multicenter study of patients with adult-onset Still's disease compared with
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systemic juvenile idiopathic arthritis. Clin Rheumatol. 2006;25:639-644. Efthimiou P, Paik PK, Bielory L. Diagnosis and management of adult onset Still's disease. Ann Rheum Dis. 2006;65(5):564-572.
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