Summary about Disease
Still's disease is a rare type of inflammatory arthritis. There are two main types: systemic juvenile idiopathic arthritis (SJIA), affecting children, and adult-onset Still's disease (AOSD), affecting adults. It's characterized by a high spiking fever, salmon-colored rash, and joint pain. The disease is systemic, meaning it can affect multiple organs.
Symptoms
High spiking fever (often once or twice a day)
Salmon-colored rash (often appearing with the fever)
Joint pain and stiffness (arthritis)
Sore throat
Muscle aches
Swollen lymph nodes
Enlarged liver or spleen
Inflammation of the lining of the heart (pericarditis) or lungs (pleuritis)
Causes
The exact cause of Still's disease is unknown. It is believed to be an autoimmune disorder, where the body's immune system mistakenly attacks its own tissues. Genetic predisposition and environmental triggers are suspected to play a role, but no specific gene or trigger has been identified.
Medicine Used
NSAIDs (Nonsteroidal anti-inflammatory drugs): To reduce pain and inflammation.
Corticosteroids: Prednisone is often used to quickly control inflammation, but long-term use has side effects.
DMARDs (Disease-modifying antirheumatic drugs): Such as methotrexate, to slow disease progression.
Biologic Response Modifiers (Biologics): TNF inhibitors (etanercept, adalimumab, infliximab), IL-1 inhibitors (anakinra, canakinumab), and IL-6 inhibitors (tocilizumab) are used to target specific immune system proteins.
Is Communicable
No, Still's disease is not communicable or contagious. It is not caused by an infection and cannot be spread from person to person.
Precautions
Follow medical advice: Adhere to prescribed medications and treatment plans.
Maintain a healthy lifestyle: Regular exercise, a balanced diet, and sufficient rest.
Avoid known triggers: If specific triggers for flares are identified, avoid them.
Protect against infection: Because the disease and its treatments can suppress the immune system, take precautions to avoid infections (e.g., frequent handwashing, avoiding close contact with sick individuals).
Regular checkups: Monitor for potential complications like organ damage or secondary infections.
How long does an outbreak last?
The duration of an outbreak varies greatly. Some individuals experience a single episode that resolves, while others have recurrent or chronic symptoms. Flares can last for days, weeks, or even months. The course of the disease is unpredictable.
How is it diagnosed?
Diagnosis is often challenging because there is no single definitive test. It relies on a combination of factors:
Medical history and physical examination: Assessing symptoms and ruling out other conditions.
Blood tests: Elevated inflammatory markers (ESR, CRP), elevated white blood cell count, elevated ferritin levels.
Imaging studies: X-rays, MRI, or ultrasound to assess joint damage and organ involvement.
Exclusion of other conditions: Ruling out infections, other autoimmune diseases, and malignancies.
Timeline of Symptoms
The timeline of symptoms is variable. Generally, the typical sequence is: 1. Initial phase: High spiking fevers and rash. 2. Early arthritis: Joint pain and stiffness emerge, often affecting multiple joints. 3. Systemic involvement: Other symptoms may develop, such as sore throat, muscle aches, enlarged lymph nodes, or organ inflammation. 4. Chronic phase (in some cases): Persistent arthritis and potential joint damage, even after other symptoms subside.
Important Considerations
Early diagnosis and treatment are crucial to prevent joint damage and systemic complications.
The disease can have a significant impact on quality of life, affecting mobility, energy levels, and mental health.
Long-term monitoring is necessary to manage the disease and potential side effects of medications.
Individual responses to treatment vary, so finding the right treatment plan may require trial and error.
Support groups and patient resources can provide valuable information and emotional support.