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Adult-Onset Still's Disease

Last Updated on Apr 07, 2014
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Adult-onset Stillís disease is a rare, inflammatory form of arthritis characterized by fever, pink rash, and swelling of joints.

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Adult-onset Stillís disease is a rare, inflammatory form of arthritis, which affects joints, tissues, lymph nodes, and internal organs. In 1971, Bywaters described a condition in adults, which resembled Stillís disease in children, and termed it adult-onset Stillís disease (AOSD).

Adult-Onset Still's Disease

The disease is rare, and occurs at a frequency of 1 in 10 000. It bears a few similarities to juvenile rheumatoid arthritis but is observed only in adults. Adults in the age range of 15 to 25, and 39 to 45 years, are often affected by AOSD. Older adults, over the age of 70 years, may also show initial symptoms of AOSD. Some of the characteristic symptoms of AOSD are pink rash, sore throat, high fever, and onset of joint pain in the space of 2 weeks.

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The exact cause of AOSD is unknown. The various possibilities are a reaction to an infection with a virus (eg, hepatitis B, hepatitis C, Epstein-Barr, influenza, rubella, cytomegalovirus, among others), or bacterium (M.pneumonia, Yersinia entercolitica). Another factor is the genetic predisposition of individuals to the disease. High stress in daily life has also been shown to be a predisposing factor inAOSD.

Diagnosis of AOSD is based on blood tests and imaging studies. It is treated with NSAIDs or anti-inflammatory drugs like glucocorticoids, methotrexate or newer drugs like anakinra and etanercept.

  1. Adult Still's disease - (http://www.mayoclinic.org/diseases-conditions/adult-stills-disease/basics/definition/con-20026609)
  2. Mahroum N, Mahagna H, Amital H. Diagnosis and classification of adult Stillís disease. J Autoimmun. 2014;48-49:34-37.
  3. Persad P, Patel R, Patel N. Adult Onset Stillís Disease and Rocky Mountain Spotted Fever. Case Rep Med. 2010;doi: 10.1155/2010/621046.
  4. Lin KM et al. Formation of Rice Bodies: an Unusual Finding of Adult-Onset Stillís Disease. Clin Rheumatol. 2008;27Suppl2:S55-57.
  5. Lee JB et al. Adult-Onset Stillís Disease with Vesiculopustules on the Hands and Feet. J Korean Med Sci. 2002;17(6):852-855.

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