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Still Disease, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

68 pages48 minutes


This book describes Still Disease, Diagnosis and Treatment and Related Diseases
Still disease is a serious type of juvenile idiopathic arthritis (JIA), which happens in children.
Adults can have the same condition, even though it is much less common.
It is also called adult-onset Still disease (AOSD).
Still disease is a rare type of inflammatory arthritis that features fevers, rash and joint pain.
Some people have just one event of Still disease
In other people, the disorder persists or recurs.
This inflammation can damage affected joints, particularly the wrists.
It may result in long-term (chronic) arthritis.
Still disease (SD) is a multi-system inflammatory disease that normally starts with a sore throat.
Non-suppurative pharyngitis (throat infection) may form days to weeks before the typical fever, salmon-colored rash, and joint pains begin.
Other systemic symptoms soon follow, such as profound fatigue, weight loss, and anorexia.
The cause of Still disease is not known.
The presence of daily spiking fevers has focused research efforts on the possibility that the cause of SD is infection-related.
To date, there has not been any infectious agent or genetic predisposition identified in patients with this disease
Risk factors
Age is the main risk factor for Still disease, with incidence peaking twice:
1. Once from 15 to 25 years and
2. Again from 36 to 46 years.
Nearly all people with the disease will have fever, joint pain, sore throat, and a rash.
Joint pain, warmth, and swelling are frequent.
Most often, several joints are affected at the same time.
Often, people with the disorder get morning stiffness of joints that lasts for several hours.
The fever comes on quickly once per day, most often in the afternoon or evening.
The skin rash is often salmon-pink colored and appears and disappears with the fever.
Additional symptoms are:
1. Abdominal pain and swelling
2. Pain when taking a deep breath (pleurisy)
3. Swollen lymph nodes (glands)
4. Weight loss
5. The spleen or liver may become enlarged.
6. Lung and heart inflammation may also happen.
Still Disease can only be diagnosed after many other diseases (such as infections and cancer) are excluded.
The patient may require many medical tests before a final diagnosis is made.
A physical examination may show a fever, rash, and arthritis.
1. Full blood count -a high number of white blood cells and reduced number of red blood cells.
2. C-reactive protein (CRP), will be higher
3. ESR (sedimentation rate), will be higher
4. Ferritin level will be very high.
5. Fibrinogen level will be high.
6. Liver function tests will show high levels of AST and ALT.
7. Rheumatoid factor and ANA test will be negative.
Other tests may be required to check for inflammation of the joints, chest, liver, and spleen.
Studies have documented raised levels of interleukin-18 that link with medical activity of SD.
Imaging tests can show joint, heart and lung damage caused by the disease
The purpose of treatment for Still disease is to control and relieve the symptoms of arthritis.
Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are most often given first.
Prednisone may be given for more serious cases.
If the disease lasts for a long time (becomes chronic), medicines that suppress the immune system might be required.
1. Methotrexate
2. Anakinra (interleukin-1 receptor agonist)
3. Tocilizumab (interleukin 6 inhibitor)
4. Tumor necrosis factor (TNF) antagonists such as etanercept
Exercise can help the patient sustain the range of motion and alleviate pain and stiffness
Treatment is normally continued until remission.

Chapter 1 Still Disease
Chapter 2 Causes

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