Adult Still’s Disease: Symptoms Diagnosis Treatment

Adult Still’s Disease main symptoms are rashes, fevers, and joint pain are all symptoms of adult Still’s disease, an uncommon form of inflammatory arthritis. Some adults with Still’s disease only have one attack. The issue persists or returns for some people.

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Wrist joints, in particular, are vulnerable to harm from inflammation. Inflammation-reducing drugs like prednisone are used to treat the disorder.

Symptoms of Adult Still’s Disease

Most adults with Still’s disease have a mix of the following symptoms and signs:

  • Fever. You might have a fever of at least 102 F (38.9 C) every day for at least a week. Most of the time, the fever is at its worst in the late afternoon or early evening. You might have two fever spikes a day, with periods when your temperature goes back to normal.
  • Rash. With the fever, a salmon-colored rash might come and go. Most of the time, the rash shows up on your trunk, arms, or legs.
  • Throat pain. This is one of the early signs of Still’s disease in adults. If your lymph nodes in the neck are swollen, you may feel some discomfort.
  • Joint pain and swelling. Your knees and wrists, in particular, may be stiff, painful, and swollen. You might also feel pain in your ankles, elbows, hands, and shoulders. Most of the time, the joint pain lasts at least two weeks.
  • Muscle pain. Muscle pain usually comes and goes with the fever, but it can be bad enough to stop you from going about your daily life.

The signs and symptoms of this disorder can look like those of other diseases, like lupus and lymphoma, which are both types of cancer.

When to go to the doctor

See a doctor if you have a high fever, a rash, and sore joints. Also, if you are an adult with Still’s disease and you get a cough, trouble breathing, chest pain, or any other strange symptoms, you should call your doctor.

Causes of Adult Still’s Disease

Still’s disease in adults doesn’t have a clear cause. Some researchers think that a bacterial or viral infection might have caused the condition.

Risk factors

Still’s disease in adults is most likely to happen because of age. The disease is most common between the ages of 15 and 25 and 36 and 46. Both men and women are in danger.


Most problems that come up with Still’s disease in adults are caused by long-term inflammation of organs and joints.

  • Joint destruction. Joints can be hurt by long-term inflammation. The knees and wrists are the joints that get hurt the most. Less often, your neck, foot, finger, and hip joints may also be affected.
  • Heart pain and swelling. Still’s disease in adults can cause inflammation of either the sac-like covering of the heart (pericarditis) or the muscle part of the heart (myocarditis).
  • You have too much fluid around your lungs. When you have inflammation, fluid can build up around your lungs, making it hard to take deep breaths.
  • The syndrome of activated macrophages. This rare but potentially fatal complication of adult Still’s disease can lead to low blood cell counts, very high triglyceride levels, and abnormal liver function.


Still’s disease in adults can’t be found with just one test. Imaging tests can show how much damage the disease has done, and blood tests can help rule out other diseases with similar symptoms.

Treatment of Adult Still’s Disease

Different drugs are used to treat adults with Still’s disease. What kind of drug you take will depend on how bad your symptoms are and if you have any side effects.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs like ibuprofen (Advil, Motrin like ibuprofen, and others) and naproxen sodium (Aleve) can be bought over the counter and may help with mild joint pain and inflammation. You can get stronger NSAIDs with a prescription. Because NSAIDs can hurt the liver, you might need regular blood tests to check how well your liver is working.
  • Steroids. Steroids, such as prednisone, are used to treat most adults with Still’s disease. These strong drugs can reduce inflammation, but they may also lower your body’s ability to fight off infections and make you more likely to get osteoporosis.
  • Methotrexate. Methotrexate (Trexall) is often used together with prednisone, which makes it possible to lower the dose of prednisone
  • Biologic response modifiers. Some drugs, like infliximab (Remicade), adalimumab (Humira), and etanercept (Enbrel), have shown promise, but we still don’t know what their long-term effects will be. If other medicines haven’t helped, your doctor may suggest you try anakinra (Kineret), tocilizumab (Actemra), or rituximab (Rituxan).

How you live and what you do at home

If you have adult Still’s disease, here are some ways to take care of your health:

  • Know what your medicines do. Even if you don’t have any symptoms some days, you should still take your medicines as your doctor tells you to. Getting rid of inflammation helps lower the risk of problems.
  • Supplement your diet. If you take a lot of prednisone, talk to your doctor about taking more calcium and vitamin D supplements to help prevent osteoporosis.
  • Keep moving. Even if your joints hurt, you might not want to work out, but exercise is good for all types of arthritis. Exercise can help you keep your flexibility and ease pain and stiffness.

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