Arthritis

Adult-Onset Still’s Disease: Everything Important

Arthritis has many forms, and Still’s disease is a rare type of inflammatory arthritis that is also known as Systemic Juvenile Idiopathic Arthritis or Adult-Onset Stills Disease (AOSD). As you might have guessed by the name, AOSD is diagnosed only in adults. What makes Still’s Disease different than other types of arthritis? It does have symptoms similar to other forms of arthritis, but there are subtle differences, and hopefully, I can shine a light on some of these and give you a better idea of what Adult-onset Still’s Disease (AOSD) is.

Still’s Disease…What?

I’m sure you’re familiar with arthritis and the aches and pains associated with it. What makes Still’s Disease different from your typical run-of-the-mill arthritis? Still’s Disease can be classified into two distinct types depending on when it was diagnosed. They are:

1. Systemic-onset Juvenile Idiopathic Arthritis (JIA): This form of Still’s Disease was first diagnosed in children and is a type of juvenile idiopathic arthritis affecting children.
2. Adult-onset Still’s Disease: This form of Still’s Disease is thought to be the same condition as JIA but is only diagnosed in adults.

Adult-onset Still’s Disease is an autoimmune condition where the body’s immune system, which normally protects us from infection, attacks our bodies by mistake. This condition can occur as a single episode and go away, be persistent, or even go away and return. This condition can damage joints, particularly the wrists, and without a cure, medicines are needed to reduce pain and control this disease.

Symptoms of Adult-Onset Still’s Disease

The one basic thing all types of arthritis have is joint inflammation and pain. So, what makes Adult-Onset Still’s disease different? Some of the signs & symptoms of AOSD include:

• Sore throat
• Joint pain
• Fever
• Rash
• Muscle pain
• Swollen joints

What makes this disease difficult to diagnose is that someone living with Still’s Disease may not experience these symptoms all at once but maybe one at a time. For instance, a fever associated with Still’s may go up and down a few times during the day, but some may experience a fever continuously or just spikes in the morning. These symptoms can appear suddenly (known as a flare) or over time, and the flares can be frequent or years apart. Talk about complicated!!

Complications

Besides joint pain and swelling, complications of AOSD can be:

• Enlargement of spleen/liver
• Interstitial lung disease (scarring of the lung)
• Pleural effusion
• Pericarditis (inflammation of tissue around the heart)

Cause and Diagnosis

Adult-Onset Still’s Disease can be debilitating, so what causes it, and how do we get it diagnosed? Unfortunately, the cause of this disease is still unknown (no pun intended). Generally, it affects those between the ages of 16-35, but adults of any age can develop this disease, and it seems to affect more women than men. While it may be genetic, there appears to be a need for an environmental trigger. To add another layer of difficulty to this disease, there’s no single test for AOSD. Your physician (who may not encounter anyone else with AOSD) may base a diagnosis on the following:

• Symptom history
• Blood test
• Physical exam
• Process of illumination of other diseases

Blood tests typically show a high level of inflammation in those with AOSD. This inflammation can manifest itself during two blood tests known as Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP).

Treatments for Adult-Onset Still’s Disease

With no cure for this disease, how do we treat Still’s disease? Once you’re diagnosed with Still’s Disease, you should see a specialist like a rheumatologist. Treatment to manage symptoms of Still’s Disease are:

• NSAIDs (aspirin, ibuprofen, naproxen etc.)
• Steroids
• Disease-modifying antirheumatic drugs
• Exercise

When to See Your Doctor

Since Still’s Disease can be difficult to diagnose, how do you know when to see your doctor? Often, these symptoms can be confused with other common problems. You should contact your doctor if you experience a cough, breathing issues, or chest pain along with joint pain or stiffness.

Adult-onset Still’s Disease not only can be rare but also difficult to diagnose. It is important for you to be your own best advocate if you think you are being affected by AOSD. At HPFY, find all that you need to manage symptoms of Still's Disease and maintain your quality of life and lifestyle.

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