Still's disease is a form of juvenile rheumatoid arthritis (JRA), characterized by high spiking fevers and transient rashes, named after the English physician Sir George F. Still (1861-1941). The disease was first discovered in children, but now it is also known to occur, less commonly, in adults in whom it is referred to as adult-onset Still's disease.

There are several theories about the cause of Still's disease. It has been suggested it may be caused by a microbacterial infection or that it is an autoimmune disorder. However, the cause of Still's disease remains unknown.

Symptoms

Patients with Still's disease usually have body wide symptoms. They usually have waves of high fevers that rise to 104 °F (40 °C) which may be accompanied by extreme fatigue. A faint transient non-itching salmon-colored skin rash can also be observed.

Other symptoms commonly include swelling of the lymph glands , enlargement of the spleen and liver, and sore throat. Some patients develop inflammation of the pleura (the lining around the lungs) or the pericardium (the lining around the heart) with fluid accumulation.

Although the arthritis may initially be overlooked because of the other symptoms, everyone with Still's disease eventually develops pain and swelling in several joints. Though any joint can be affected, some joints (like the wrists) are more likely to be affected by the disease than others.

Diagnosis

In order to diagnose Still's disease, the results of a number of common tests need to be combined. Firstly, persistent arthritis (lasting at least 6 weeks) needs to be present. Patients often have elevated white blood cell counts, suggesting they are seriously infected. Also, low counts for red blood cells (anemia) and elevated blood tests (such as sedimentation rates) for inflammation are common. However, the classic blood tests for rheumatoid arthritis and systemic lupus erythematosus are usually negative.

Prognosis

The fever and most of the other symptoms tend to run their course within several months. However, the arthritis can become a long-term problem as a chronic illness persisting into adulthood.

External links

• AOSD Web site
• Arthritis.org
• The AOSD Message Board
• Still's disease at medicinenet.com