Adult Onset Still’s Disease
Adult Onset Still’s DiseaseA 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.