Rheumatology: Current Research
Open Access

Overview on Adult Still's Disease

Laurence Paul^{* *}Correspondence: Laurence Paul, Department of Arthritis, Purdue University, West Lafayette, United States, Email:

Author info »

Description

Adult Still's disease is a rare form of inflammatory arthritis characterised by fevers, rashes, and joint pain. Adult Still's illness affects some persons only once. The condition remains or recurs in some persons. This inflammation has the potential to ruin the affected joints, especially the wrists. Prednisone and other anti-inflammatory medicines are used in treatment.

Symptoms

Adults with Still's illness typically exhibit a combination of the following signs and symptoms:

• For a week or more, you may have a daily temperature of at least 102 F (38.9oC). Late afternoon or early evening is when the fever normally peaks. Two fever spikes each day are possible, with your temperature returning to normal in between.

• With the fever, a salmon-pink rash may appear and disappear. The rash most commonly develops on the trunk, arms, or legs.

• One of the earliest signs of adult Still's illness is this. Swollen and sore lymph nodes in your neck are possible.

• It's possible that your joints, particularly your knees and wrists, are tight, uncomfortable, and inflamed. Aches in the ankles, elbows, hands, and shoulders are also possible. The soreness in the joints normally lasts at least two weeks.

• Muscle discomfort normally comes and goes with the temperature, but it can be severe enough to cause you to miss work.

The signs and symptoms of this ailment can be mistaken for those of other diseases such as lupus and lymphoma.

Causes and risk factors

The cause of adult Still's disease is unknown. Some scientists believe the disease is caused by a viral or bacterial infection. Adult Still's disease is mostly caused by ageing, with incidence rising twice: once between the ages of 15 and 25, and again between the ages of 36 and 46. Both males and females are at risk.

Tests performed for diagnosis of adult still's disease

Many other disorders (such as infections and cancer) must be cleared out before AOSD can be diagnosed. Many medical tests may be performed before a definite diagnosis may be reached. A fever, rash, or arthritis may be discovered during a physical examination. A stethoscope will be used by the health care practitioner to listen for changes in the sound of your heart or lungs. The following blood tests can be helpful in diagnosing adult Still disease:

• A large number of white blood cells (granulocytes) and a low number of red blood cells can be seen on a Complete Blood Count (CBC).

• The inflammatory marker C-reactive Protein (CRP) will be greater than normal.

• ESR (sedimentation rate), an inflammatory marker, will be greater than normal.

• The level of ferritin will be extremely high.

• The level of fibrinogen will be high.

• AST and ALT levels will be elevated on liver function tests.

• The ANA and rheumatoid factor tests will be negative.

• The results of blood cultures and virus tests will be negative.

Complications

The majority of adult Still's disease problems are caused by persistent inflammation of the organs and joints.

• Chronic inflammation can cause joint injury. Knees and wrists are the most usually affected joints. Your neck, foot, finger, and hip joints may also be impacted, though this is rare.

• Adult Still's disease can cause inflammation of the heart's saclike covering (pericarditis) or the muscular portion (myocarditis) (myocarditis).

• Fluid can build up around your lungs as a result of inflammation, making it difficult to breathe deeply.

• Low blood cell counts, very high triglyceride levels, and altered liver function are all symptoms of this unusual but possibly fatal consequence of adult Still's disease.