Adult Onset Still's Disease

Adult Onset Still’s Disease

A rare form of Still’s disease—acute febrile onset of arthritis in adults.
Clinical findings Multiple remissions and exacerbations, reduced wrist extensibility, carpal ankylosis, distal interphalangeal joint involvement; other features include daily fever spikes, reduced range of motion of neck, pericarditis, pleural effusions, severe abdominal pain, evanescent pink macules most prominent when febrile.
Lab Normal rheumatoid factor, anti-nuclear antibody (ANA), complement.
Management NSAIDs, glucocorticoids, methotrexate; biologic response modifiers—e.g., TNF-alpha blockers, infliximab, etanercept, adalimumab, rituximab, cyclosporine and anakinra have been used to treat adult Still's disease.

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