Understanding Still's Disease: Causes, Symptoms, and Management

What is it?

Adult-onset Still’s disease is a rare type of arthritis that is thought to be autoimmune 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.

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Additional names

This group contains additional names:
- Jra (juvenile rheumatoid arthritis)
- Juvenile rheumatoid arthritis
- Juvenile seronegative polyarthritis
- Polyarticular juvenile rheumatoid arthritis
- Rheumatoid arthritis with organ / system involvement
- Systemic rheumatoid arthritis
- JIA
- Juvenile idiopathic arthritis

Signs & symptoms

Most people with adult Still's disease have a combination of the following signs and symptoms:
- Fever: for a week or longer. The fever usually peaks in the late afternoon or early evening.
- Rash: A salmon-pink rash might come and go with the fever. The rash usually appears on the trunk, arms or legs.
- Sore throat: This is one of the first symptoms of adult Still's disease. The lymph nodes in the neck might be swollen and tender.
- Achy and swollen joints: Especially the knees and wrists - might be stiff, painful and inflamed. Ankles, elbows, hands and shoulders might also ache. The joint discomfort usually lasts at least two weeks.
- Muscle pain: Muscular pain usually ebbs and flows with the fever, but the pain can be severe enough to disrupt the daily activities.

The signs and symptoms of this disorder can mimic those of other conditions, including lupus and a type of cancer called lymphoma.

Diagnosis

No single test identifies adult Still's disease. Imaging tests can reveal damage caused by the disease, while blood tests can help rule out other conditions that have similar symptoms.

Treatment

Variety of drugs might treat adult Still's disease. The type depends on the severity of the symptoms and side effects.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): May help with mild joint pain and inflammation.
- Steroids: Most people who have adult Still's disease require treatment with steroids, such as prednisone. These powerful drugs reduce inflammation, but may lower the body's resistance to infections and increase the risk of developing osteoporosis.
- Methotrexate: Often used in combination with prednisone, which allows the prednisone dose to be reduced.
- Biologic response modifiers: Drugs such as infliximab (Remicade), adalimumab (Humira) and etanercept (Enbrel) have shown some promise, but their long-term benefit is still unknown.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

Learn more about our editorial process for content accuracy.

Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital