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What is Adult-Onset Still’s Disease?
Adult Still’s disease is a rare type of arthritis that features a sore throat, a salmon-colored rash and a high fever that spikes once or twice a day. Joint pain tends to develop a few weeks after these initial signs and symptoms.
The cause of adult Still’s disease is unknown, but researchers are investigating the possibility that it might be triggered by some type of infection. Some people experience just one episode of adult Still’s disease. In other people, the condition persists or recurs.
What Causes Adult-Onset Still’s Disease?
The causes of adult Still’s disease are still unknown. Doctors suspect that the condition may be related to certain antigens (substances that cause your body to produce antibodies to fight infection). Some people may just be genetically predisposed to the condition.
What are symptoms and signs of Adult-Onset Still’s Disease?
Still’s disease usually begins with systemic (body-wide) symptoms. Extreme fatigue can accompany waves of high fevers that rise daily to 102 F (39 C) or even higher and rapidly return to normal levels or below. Fever spikes often occur at approximately the same time every day. A faint salmon-colored skin rash characteristically comes and goes and does not itch.
Poor appetite, nausea, and weight loss are common. There is also commonly swelling of the lymph glands, enlargement of the spleen and liver, and sore throat. Some patients develop inflammation around the heart (pericarditis) and lungs (pleuritis), with occasional fluid accumulation around heart (pericardial effusion) and lungs (pleural effusion). Arthritis, with joint swelling, often occurs after rash and fevers have been present for some time. Although the arthritis may initially be overlooked because of the impressive nature of the systemic symptoms, everyone with Still’s disease eventually develops joint pain and swelling. This usually involves many joints (polyarticular arthritis). Any joint can be affected, although there are preferential patterns of joint involvement in Still’s disease.
Who is at Risk for Adult-Onset Still’s Disease?
People between the ages of 16 and 46 are at a higher risk for AOSD. The condition affects women at a slightly higher rate than men. Recent research suggests that adult Still’s disease is probably not hereditary.
Treating Adult-Onset Still’s Disease
Because the initial symptoms of AOSD are often followed by the onset of arthritis, doctors will usually focus their treatment on addressing the arthritis. One of the most common treatments involves taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve). Prescription drugs such as prednisone may also be used.
More powerful drugs used to treat extreme cases of Still’s disease are called glucocorticoids, which are a category of corticosteroid drugs. Your doctor might try to limit the use of these drugs, however, because of their side effects, which can include high blood pressure and fluid retention. If your AOSD becomes chronic, medicines that suppress your immune system might be necessary. Such medicines include anakinra (Kineret), methotrexate (Rheumatrex), and etanercept (Enbrel).