Disease: Adult Still's disease
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.
It's not certain what causes adult Still's disease. Some researchers suspect the condition might be triggered by a viral or bacterial infection.
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.
Most complications from adult Still's disease arise from chronic inflammation of organs and joints.
- Joint destruction. Chronic inflammation can damage your joints. The most commonly involved joints are your knees and wrists. Your neck, foot, finger and hip joints also may be affected, but much less frequently.
- Inflammation of your heart. Adult Still's disease can lead to an inflammation of the saclike covering of your heart (pericarditis) or of the muscular portion of your heart (myocarditis).
- Excess fluid around your lungs. Inflammation may cause fluid to build up around your lungs, which can make it hard to breathe deeply.
- Macrophage activation syndrome. This rare, but potentially fatal complication of adult Still's disease, can cause low blood cell counts, very high triglyceride levels and abnormal liver function.
Lifestyle and home remedies
Here are ways to make the most of your health if you have adult Still's disease:
- Understand your medications. Even if you're symptom-free some days, it's important to take your medications as your doctor recommends. Controlling inflammation helps reduce the risk of complications.
- Supplement your diet. If you're taking high doses of prednisone, talk to your doctor about taking more calcium and vitamin D supplements to help prevent osteoporosis.
- Keep moving. Although you might not want to work out if your joints ache, exercise is recommended for all types of arthritis. Exercise can help you maintain your range of motion and relieve pain and stiffness.
Age is the main risk factor for adult Still's disease, with incidence peaking twice: once from 15 to 25 years and again from 36 to 46 years. Males and females are equally at risk.
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