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Adult Still's disease

Contents of this page:

Alternative Names   

Still's disease - adult; AOSD

Definition    Return to top

Adult Still's disease is a rare illness marked by high fevers, rash, and joint pain. It may lead to long-term (chronic) arthritis.

It is more commonly called adult-onset Still's disease (AOSD).

Causes    Return to top

Fewer than 1 out of 100,000 people develop adult Still's disease each year. It affects women more often than men.

Still's disease that occurs in children is called systemic juvenile idiopathic arthritis.

The cause of adult Still's disease is unknown. No risk factors for the disease have been identified.

Symptoms    Return to top

Almost all patients will have fever, joint pain, sore throat, and a rash.

Additional symptoms include:

Occasionally, the spleen or liver may become swollen. Lung and heart inflammation may occur.

Exams and Tests    Return to top

Adult Still's disease can only be diagnosed after other diseases are ruled out. You may need many medical tests before a final diagnosis is made.

A physical exam may reveal a fever, rash, and arthritis. The health care provider will use a stethoscope to listen for changes in the sound of the heart or lungs.

The following blood tests can be helpful in diagnosing adult Still's Disease.

Other tests may be needed to check for inflammation of the joints, chest, liver, and spleen.

Treatment    Return to top

The goal of treatment for adult Still's disease is to control the symptoms of arthritis. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are usually the first form of treatment.

Prednisone may be used for more severe cases.

If the disease persists for a long time (becomes chronic), medicines that suppress the immune system might be needed. Such medicines include:

Outlook (Prognosis)    Return to top

Studies show that in about 20% of patients, all symptoms go away in a year and never come back. In about 30% of patients, all symptoms go away but then come back several times over the next years.

Symptoms continue for a long-time (chronic) in about half of patients with adult Still's disease.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if you have symptoms of Adult Still's disease.

If you have already been diagnosed with the condition, you should call your health care provider if you have a cough or difficulty breathing.

References    Return to top

Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB. Kelley's Textbook of Rheumatology. 7th ed. St. Louis, Mo: WB Saunders; 2005:1047-1048.

Pay S, Turkcapar N, Kalyoncu M, et al. A multicenter study of patients with adult-onset Still's disease compared with systemic juvenile idiopathic arthritis. Clin Rheumatol. 2005 Dec 20;:1-6.

Efthimiou P, Paik PK, Bielory L. Diagnosis and management of adult onset Still's disease. Ann Rheum Dis. 2006 May;65(5):564-72. Epub 2005 Oct 11. Review.

Kadar J, Petrovicz E. Adult-onset Still's disease. Best Pract Res Clin Rheumatol. 2004 Oct;18(5):663-76. Review.

Update Date: 2/3/2009

Updated by: Mark James Borigini, Associate Clinical Professor of Medicine, University of California, Irvine, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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