Information for Still's Disease Sufferers

What is Still's Disease?

Still’s disease is a form of juvenile idiopathic arthritis, and shares the same characteristics and symptoms. The disease causes arthritic pain, and can ultimately cause inflammation in the organs. Still’s disease can cause serious joint damage, particularly to the wrists. It can also affect normal functioning of the heart and the lungs.

• In adults, it is called adult onset Still’s disease.
• Still’s disease is a rare one for adults (a majority of whom are between 20 and 35 years of age at onset), affecting less than 1 out of 100,000 adults per year.
• The disease affects more women than men.
• In children, it is known as the “systemic” type of juvenile idiopathic arthritis.

Systemic means that along with joint inflammation the condition typically begins with symptoms and signs of systemic (body-wide) illness, such as high fevers, gland swelling, and internal organ involvement.

• It is more common in children, accounting for 10-20% of all juvenile idiopathic arthritis cases and it is a more severe form of juvenile arthritis.
• It affects boys and girls equally.
• It affects approximately 25,000-50,000 children in the United States alone.
• It usually involves many different joints.

The arthritis portion of the disease may be mild or severe, and can involve just a few, or many joints. However, even severe forms of arthritis sometimes go into remission within a few years. If the arthritis does not go into remission, it will follow a pattern of ups and downs that is different for everyone. In most cases, the pattern will gradually become less severe. Occasionally, flares may occur after the disease has been inactive for a long time.

Still’s disease is a disease with no known cause.

Do I have it?

Still's disease usually begins with symptoms that affect the whole body (systemic symptoms). People with the disease often feel very tired and experience daily fevers of 40°C or higher. These fever spikes usually occur at about the same time every day (late afternoons and evenings) and always go away after a while. A faint salmon-colored skin rash appears from time to time, usually at the height of the fevers. The rash does not itch.

If your fever, rash and achy joints persist for at least two weeks, see your doctor to determine what may be the cause. Having these symptoms might not necessarily mean that you have Still’s disease. Go see your doctor for proper diagnoses.

Does my child have it?

Children with systemic-onset juvenile arthritis have spiking (rapidly rising and falling) fever, which usually occurs once (or sometimes twice) a day, and a rash that frequently comes and goes with the fever. In addition, they often have swollen lymph glands, and enlargement of the liver and spleen. They appear listless and unwell during the fever (most often in the late afternoon or evening), only to brighten up by the next day as their temperature returns to normal.

Having these symptoms might not necessarily mean that your child has Still’s disease. Go see your doctor for proper diagnoses.

How is it diagnosed?

Diagnosing Still’s disease is often a laborious process consisting of the elimination of other diseases. It is diagnosed on a basis of clinical features of the illness, with the results of a number of common tests combined.

In the early stages, there is sometimes no sign of joint inflammation. This may make it a very difficult disease to diagnose because there are many other illnesses that also cause a fever and rash (particularly in children). Therefore, many tests are done. Routine examinations and tests include the following:

• Medical history and physical examination.
• Complete blood count (CBC) a blood test used to evaluate all the basic cellular components of blood, including red blood cells, white blood cells, and platelets.
• Erythrocyte sedimentation rate (ESR, or sed rate) which checks how rapidly red blood cells settle to the bottom of a test tube.
• An echocardiogram can detect Inflammation of the lining of the heart or lungs.
• X-rays may show changes in the wrists, spine, foot or finger joints.
• A computerized tomography (CT) scan or ultrasound may indicate an enlarged liver or spleen.
• Urinalysis.
• Rapid strep test or throat culture (to test for strep throat).

How did I get it?

Although the cause of Still’s disease is not known, researchers are currently investigating a number of possibilities:

• Infection. The abrupt appearance of high fever, sore throat, rash, lymph node swelling, and abnormal white blood cell counts suggest some kind of infectious trigger. While no particular cause of infection has been found, the rubella (German Measles) virus has been detected in many people with the disease. Researchers have also found some association between Still’s and EB, CMV, mumps, parainfluenza, and other viruses.
• Immune Disorder. Individuals with a hypersensitive or autoimmune disorder may be more susceptible.
• Genetics. Multiple cases of adult Still's disease in families are uncommon, so it's unlikely that this disorder is caused by genetics, but scientists are yet to rule this theory out completely.
• Hormonal Influences. Pregnant women are slightly more likely to come down with the disease or to have a relapse. On the other hand, if the female hormones associated with pregnancy played a role, the expection would be for adult Still’s to be more common in one sex or the other; however the disease seems to affect both sexes equally.

Age is the main risk factor for adult Still's disease, with incidence in adults peaking twice: once from 15 to 25 years and again from 36 to 46 years. Males and females are equally at risk of acquiring the disorder.

How did my child get it?

Theories regarding the cause include infection caused by microbes. Another concept is that Still's disease is a hypersensitive or autoimmune disorder.

Do you have more questions?

We encourage you to contact our office directly with any questions you may have regarding joint pain. We will do our best to answer your questions in a thorough and courteous manner.

Feel free to email us at service@mendmeshop.com. Emails will be answered promptly between 9am and 5pm (Eastern Standard Time) on weekdays.

Alternatively, for those located within the US or Canada, you may contact us on our toll free number 1-866-237-9608. If you live outside of these countries, call our local number at 705 445 3505

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