Adult Still's disease

Definition

Adult Still's disease is an illness with fever, rash, and Joint pain. It may lead to chronic arthritis.

Causes, incidence, and risk factors

The cause of Adult Still's disease is unknown. The condition rarely occurs in adults. It is more common in children, where it is called Systemic juvenile rheumatoid arthritis. No risk factors for the disease have been identified.

Symptoms

Almost all patients will have fever, Joint pain, sore throat, and a rash. The fever usually comes on quickly once per day, most commonly in the afternoon or evening. The rash is typically salmon pink colored and comes and goes with the fever.

Another common symptom is Joint pain and inflammation (warmth and swelling of the joint). Usually, several joints are involved at the same time.

Additional symptoms include swollen Lymph nodes (glands), pain with a deep breath (pleurisy), Abdominal pain and swelling, and Weight loss.

Signs and tests

The physical exam may show the fever, rash, and arthritis. Other signs include enlargement of the Lymph nodes, liver, or spleen. Also, the presence of changes in the sound of the heart or lungs may indicate pericarditis or pleurisy.

Blood tests that can be helpful in diagnosing Adult Still's Disease include:

• Elevation in the ESR (sedimentation rate)
  
• Elevation in the White Blood Cell count
  
• Elevation in liver function tests
  
• Decrease in the Red Blood Cell count
  
• Very high elevation in the Ferritin level
  
• Negative rheumatoid factor and ANA test
  

Other tests may include:

• Joint X-rays
  
• Chest x-ray that may show pericarditis or pleural effusion
  
• abdominal X-ray, CT scan or ultrasound for liver and spleen enlargement