Adult-onset Still’s disease (AOSD) is a rare
condition affecting about one in every 100,000 adults. There is also a
pediatric version called systemic onset juvenile inflammatory arthritis (SoJIA).
AOSD is classified as an inflammatory illness
that often causes fatigue and swelling in joints, tissues, organs, and lymph
nodes. The primary symptoms include:
- high fevers
- joint pain
- salmon-colored rash
The condition is characterized by episodes of
flare-up and remission. The disease can appear or disappear suddenly and never
come back. In some cases there may only be one episode. In others, an episode
may not recur until years later, or there may be multiple episodes within a few
What are the symptoms of adult-onset Still’s disease?
AOSD typically presents with a fever that
lasts for several days and increases during the night. Along with this fever,
you might experience a quick-changing rash on your skin, similar to hives.
Other symptoms of AOSD include:
- sore throat
- swollen and tender joints
- inflamed or swollen lymph nodes
- muscle pain
- abdominal pain
- pain associated with deep
- weight loss
In some extreme cases, individuals develop an
enlarged liver or spleen. The tissues around major organs like the heart and
lungs may also become inflamed. However, this complication is rare.
Risks and causes
for adult-onset Still’s disease?
People between the ages of 15 and 46 are at a
higher risk for AOSD. People within the age groups of 15 to 25 and 36 to 46 are
particularly at risk. Men and women are equally affected.
The causes of adult Still’s disease are still
unknown. The condition may be related to certain antigens, substances that
cause your body to produce antibodies to fight infection.
adult-onset Still’s disease
It may take multiple tests for your doctor to
find the correct diagnosis. Certain types of cancer, mononucleosis, and other
conditions, such as Lyme disease, that share many initial symptoms with Still’s
disease will need to be ruled out. Also, a blood test may be done to check the
level of ferritin, which is often elevated in AOSD.
The three initial symptoms that could
indicate AOSD include:
Your doctor will follow up by using additional
blood test results to learn more about the inflammation in your joints and to
help develop a treatment plan.
Your doctor will also listen to your heart
and lungs, and may use radiology tests to examine your chest, liver, and
Treating adult-onset Still’s disease
Because initial symptoms of AOSD are often
followed by the onset of arthritis, doctors will usually focus treatment on
addressing the arthritis. The most common treatment is a short course of prednisone.
Side effects can include high blood pressure
and fluid retention, so your doctor may limit usage. If your AOSD becomes
chronic, drugs that modulate your immune system might be necessary. These
- tocilizumab (Actemra) blocks IL-6
- anakinra (Kineret) blocks IL-1
(Rheumatrex) blocks dividing cells
- etanercept (Enbrel), infliximab (Remicade),
adalimumab (Humira) block TNF alpha
These drugs are also used to treat
inflammatory arthritis, such as rheumatoid arthritis, because they will lower the
doses of corticosteroids that are needed.
Self-care for adults with AOSD includes
consistent administration of prescribed medications. Exercise can help maintain
muscle and joint strength. Your doctor will likely suggest a general exercise
plan for you.
You may also be advised to take vitamin
supplements, such as calcium and vitamin D, to help prevent osteoporosis,
particularly if taking prednisone.
Outlook for adult-onset Still’s disease
Although there is no cure for AOSD, it is
treatable. If symptoms recur, treatment will help to manage inflammation.
A small number of patients with AOSD will
develop chronic arthritis with joint symptoms persisting for years. However, medications
and self-care can help.
Talk with your doctor about what options
would be most effective in treating and managing your specific AOSD symptoms.