Still's disease Rheumatology


• Still's disease is a form of arthritis that is characterized by high spiking fevers and transient
salmon-colored rash.
• First described in children, but it is now known to occur, much less commonly, in adults
• Possible Pathogenesis: Infection; hypersensitivity; or autoimmune disorder


• Extreme fatigue
• Waves of high fever 104 degrees F (41 degrees C)
• Faint salmon color skin rash comes and goes usually doesn’t itch.
• Inflammation of the lungs (pleuritis)
• Inflammation of the pericardium (pericarditis)
• Fluid accumulation around the lung (pleural effusion)
• Inflammation of the liver
• Sore throat
• Arthritis this usually involves many joints (polyarticular arthritis).


• Persistent arthritis (arthritis lasting at least 6 weeks)
• Markedly elevated white blood cell count
• Low red blood count (anemia)
• Elevated ESR
• Rheumatoid arthritis (rheumatoid factor) and systemic lupus erythematosus (antinuclear antibodies, ANA) are usually negative. Other diseases especially infections, cancer, and other types of arthritis are excluded

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• Aspirin or other non-steroid drugs (NSAIDs)
• Steroids such as prednisone, are used to treat more severe features of illness.
• Persistent illness: medications that affect the inflammatory aspects of the immune system are used.
These include:
• Hydroxychloroquine (Plaquenil)
• Penicillamine
• Azathioprine (Imuran)
• Methotrexate (Rheumatrex)
• Cyclophosphamide
• Etanercept (Enbrel)
• Infliximad (Remicade)
• Corticosteroids

May 30, 2006