Adult-Onset Still's Disease
If you have adult-onset Still's disease, you are more likely to have blood test results like these:
- A high white blood cell count and low red blood cell count
- High C-reactive protein
- High erythrocyte sedimentation rate (ESR)
- Negative antinuclear antibodies
- Negative rheumatoid factor
- High liver enzymes
- High ferritin and fibrinogen
You may have more than one imaging test, such as abdominal ultrasound or CT, or X-rays of joints, chest, or abdomen. These tests may check for the following:
- An inflamed heart lining (pericarditis)
- Fluid buildup in between the lining of the lungs and chest cavity (pleural effusion)
- An enlarged spleen, liver, or lymph nodes
- Joint inflammation or damage
Once you've received a diagnosis, what can you expect? The course of the disease is difficult to predict. But these statistics may give you some idea of what may happen.
- 1 in 5 people have symptoms that go away and never come back.
- About 1 in 3 have symptoms that go away but come back several times over several years. These relapses are often less severe and shorter than the first episode.
- 1 in 2 people have symptoms that last a long time, with the disease sometimes affecting vital organs.
Treatment for Adult-Onset Still's Disease
It isn't yet possible to prevent Still's disease, and there is no cure. If you've been diagnosed, the goal is to control symptoms and the course of the disease. This can help prevent or lessen any complications.
Early treatment for adult-onset Still's disease is aimed at controlling symptoms of arthritis with nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and high-dose aspirin. These may begin even before your diagnosis is confirmed. Analgesics, or pain drugs, may also be prescribed.
You may require these medications for some time. If so, your doctor will likely monitor your liver function and watch for other side effects.
With a firm diagnosis of adult-onset Still's disease, you may require corticosteroids, such as prednisone, if your disease is severe or doesn't respond to NSAIDs. Corticosteroids are used for systemic disease that affects several parts of the body. Because of potential serious side effects, though, you can't use them for a very long time.
If you have a chronic case of Still's, you may need medications to suppress your immune system and to control arthritis and other symptoms. You may take more than one medication at the same time and you may need to take these for a long time. You take some medications by mouth and others by injection.
These are examples of medications your doctor may prescribe:
If adult-onset Still's disease affects your heart or lungs, your doctor may also need to prescribe medication to treat these problems.