Adult Still's disease
What is it?
It is a rare systematic inflammatory disease described by George Still in 1870.
Causes and risk factors
The disease affects between 25,000 and 50,000 children in the United States, while the adult form is relatively rare.
Usually, the first symptoms appear in patients aged 20 to 35 years, but cases with a later manifestation have been described. Sometimes previously transient episodes in childhood are revealed.
The reason is unknown.
Which are the symptoms?
Among the most frequent manifestations:
- general malaise;
- transient salmon-colored rash;
- arthralgia and / or oligopolyarthritis;
- fleeting skin rash without itching (on the trunk and limbs);
- serositis (pleurisy, pericarditis);
- enlarged liver and spleen;
- sore throat and myocarditis.
In laboratory studies, neutrophilic leukocytosis is often found. There is also an increase in the ESR index and, as a rule, a noticeable increase in ferritin.
Sometimes there is an increase in the activity of liver enzymes. Rheumatoid factor and antinuclear antibodies (ANA) are absent. Diagnosis requires the exclusion of other infections, rheumatological and tumor diseases.
How is it diagnosed?
How is it treated?
Treatment is based on the use of high doses of non-steroidal anti-inflammatory drugs. In the absence of a reaction, corticosteroids may be required.
Drugs that can change the development of the disease (hydroxychloroquine, azathioprine, methotrexate) are also used. Overall, the development is favorable. Chronic arthritis may persist as the systemic manifestations cease.
Where do we treat it?
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