Adult Still’s disease
- By sahlhealth
- May 18, 2021
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Adult Still’s disease is a rare type of inflammatory arthritis that features fevers, rash and joint pain. Some people have just one episode of adult Still’s disease. In other people, the condition persists or recurs.
This inflammation can destroy affected joints, particularly the wrists. Treatment involves medications, such as prednisone, that help control inflammation.
Most people with adult Still's disease have a combination of the following signs and symptoms:
Fever. You might have a daily fever of at least 102 F (38.9 C) for a week or longer. The fever usually peaks in the late afternoon or early evening. You might have two fever spikes daily, with your temperature returning to normal in between.
Rash. A salmon-pink rash might come and go with the fever. The rash usually appears on your trunk, arms or legs.
Sore throat. This is one of the first symptoms of adult Still's disease. The lymph nodes in your neck might be swollen and tender.
Achy and swollen joints. Your joints â€” especially your knees and wrists â€” 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 your daily activities.
The signs and symptoms of this disorder can mimic those of other conditions, including lupus and a type of cancer called lymphoma.
When to see a doctor
If you have a high fever, rash and achy joints, see your doctor. Also, if you have adult Still's disease and develop a cough, difficulty breathing, chest pain or any other unusual symptoms, call your doctor.
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.
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 have side effects.
Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), may help with mild joint pain and inflammation. Stronger NSAIDs are available by prescription. NSAIDs can damage the liver, so you may need regular blood tests to check liver function.
Steroids. Most people who have adult Still's disease require treatment with steroids, such as prednisone. These powerful drugs reduce inflammation, but may lower your body's resistance to infections and increase your risk of developing osteoporosis.
Methotrexate. The medication methotrexate (Trexall) is 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. If other medications haven't worked, your doctor may suggest trying anakinra (Kineret), tocilizumab (Actemra) or rituximab (Rituxan).