Adult Still’s Disease: Causes, Symptoms, Treatment and Risk Factors

Overview

Adult-onset Still’s disease is also known as Wissler-Fanconi syndrome. It is a form of a rare type of inflammatory arthritis with no known cause. This condition causes high fever, swelling in the joints, organs, lymph nodes, and tissues, and rashes. Some patients with Still’s disease may experience only one episode. However, for a few others, the condition may persist or recur. The inflammation may destroy joints that are affected, particularly the wrists. The treatment involves medications such as prednisone that help control inflammation.

This blog is a comprehensive understanding of adult still’s disease, its symptoms, causes, treatment, and prevention.

What is Adult still’s disease (ASD)?

Adult Still’s Disease (ASD) is a rare type of inflammatory arthritis that causes high fevers, rash, and joint pain. It can result in long-term (chronic) arthritis. This disease is an extreme version of juvenile idiopathic arthritis (JIA), which occurs in children. 

What are the symptoms of Adult Still’s disease?

The most common symptom of Adult Still’s disease is a fever that lasts for many days and peaks (spikes) at the same time every day. For some people, the fever can spike twice a day, at the same time each day. The patient may also notice a quick-changing salmon-pink rash on the skin that can look similar to hives. Usually, the rash appears on your trunk, arms or legs. Unlike hives, the rash is not itchy.

The other symptoms of Adult Still’s disease include:

• Sore throat
• Swelling in the knee and tender joints
• Muscle pain
• Abdominal pain
• Weight loss
• Inflamed or swollen lymph nodes
• Pain associated with deep breathing

The liver or spleen can become enlarged in rare cases. The tissues around major organs such as the heart and lungs can also be inflamed. A rare complication of this disease is macrophage activation syndrome (MAS), which can lead to serious, sometimes life-threatening, inflammation in the body. 

The signs and symptoms of this condition mimics those of other disorders, including lupus and lymphoma, a type of cancer.

When should you call the doctor?

If you are experiencing a high fever, rash, and achy joints, then you must consult the doctor. If you also have adult Still’s disease and develop a cough, difficulty breathing, chest pain, or any other unusual symptoms, consult the doctor.

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What causes Adult Still’s disease?

The causes of Adult Still’s disease are uncertain. A few researchers believe that a viral or bacterial infection may trigger the condition.

What are the risk factors of Adult Still’s disease?

Age is the chief risk factor for Adult Still’s disease. The incidence peaks twice: once from 15 – 25 years of age and again from 36 – 46 years of age. Both genders are equally at risk.

What are the complications of Adult Still’s disease?

A rare form of the disease known as macrophage activation syndrome can be very severe with high fevers, severe illness, and low blood cell counts. The bone marrow is involved, and a biopsy is required to make the diagnosis. The other complications can include:

• Liver disease
• Pleural effusion
• Arthritis in several joints
• Pericarditis
• Spleen enlargement

How is Adult Still’s Disease Treated?

In the early stages of  Adult Still’s disease, the doctor may prescribe nonsteroidal anti-inflammatory medications, such as ibuprofen, naproxen, and steroid hormones, to minimise inflammation, pain, and fever and prevent long-term damage to the joints. When steroids are used, doctors prescribe other drugs to protect against possible side effects from steroids, including infection, stomach ulcers, and weak bones.

Painkillers such as codeine and tramadol may also help. In severe or chronic cases, the doctor can prescribe immunosuppressive drugs that stop the immune system from attacking healthy tissue. Even after the symptoms stop, the doctors may recommend patients with Still’s disease to continue with the medications to keep inflammation under control. 

What lifestyle changes and home remedies can help patients with Still’s disease?

People can improve their health if they have Adult Still’s disease by:

• Understanding the medications – even if people are symptom-free for some days, they need to take the medicines as the doctor recommends. Controlling inflammation helps minimise the risk of complications.
• Supplementing the diet – if people take high doses of prednisone, they must talk to the doctor about taking more of vitamin D and calcium supplements to prevent osteoporosis.
• Keep moving – although people may not want to work out if their joints ache, exercise is recommended for all types of arthritis. Exercise can help people maintain their range of motion and relieve pain and stiffness.

Conclusion

Currently, there is no cure for Adult Still’s disease. However, regular treatment can help people manage their symptoms if they occur again. A small number of people with this disease will develop chronic arthritis with symptoms that persists for years. However, medications and self-care can help. People must consult the doctor about the best treatment options to treat and manage the symptoms of Adult Still’s disease.

Frequently Asked Questions (FAQs)

1. How is Adult Still’s disease diagnosed?

There is no single test that identifies Adult Still’s disease. Imaging tests can reveal the extent of the joint damage caused by the disease, while blood tests may help rule out other conditions with similar symptoms.

2. Can Adult Still’s disease be prevented?

There is no known way in which Adult Still’s disease can be prevented.

3. Does Adult Still’s disease resemble other conditions?

Adult Still’s disease can mimic other conditions. They include:

• Inflammatory bowel disease
• Reactive arthritis (a form of arthritis)
• Sweet syndrome (a skin disease)
• Certain cancers such as lymphoma and leukaemia
• Certain infections such as tuberculosis, toxoplasmosis, and mononucleosis