Adult Still's disease

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Still's disease - adult; AOSD

Almost all patients will have fever, joint pain, sore throat, and a rash.

• Joint pain, warmth, and swelling are common. Usually, several joints are involved at the same time. Often, patients have morning stiffness of joints that lasts for several hours.
• The fever usually comes on quickly once per day, most commonly in the afternoon or evening.
• The skin rash is typically salmon-pink colored and comes and goes with the fever.

Additional symptoms include:

• Abdominal pain and swelling
• Pain with a deep breath (pleurisy)
• Sore throat
• Swollen lymph nodes (glands)
• Weight loss

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Occasionally, the spleen or liver may become swollen. Lung and heart inflammation may occur.

Adult Still's disease can only be diagnosed after other diseases are ruled out. You may need many medical tests before a final diagnosis is made.

A physical exam may reveal a fever, rash, and arthritis. The health care provider will use a stethoscope to listen for changes in the sound of your heart or lungs.

The following blood tests can be helpful in diagnosing adult Still's disease:

• Complete blood count (CBC) may show a high number of white blood cells and reduced number of red blood cells.
• C-reactive protein (CRP), a measure of inflammation, will be higher than normal.
• ESR (sedimentation rate), a measure of inflammation, will be higher than normal.
• Ferritin level will be very high.
• Fibrinogen level will be high.
• Liver function tests will show high levels of AST and ALT.
• Rheumatoid factor and ANA test will be negative.

Other tests may be needed to check for inflammation of the joints, chest, liver, and spleen:

• Abdominal ultrasound
• CT scan of the abdomen
• X-rays of the joints, chest, or stomach area (abdomen)

Review Date: 02/07/2011
Reviewed By: Michael E. Makover, MD, professor and attending in Rheumatology at the New York University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).