Adult-Onset Still's Disease
Diagnosis of Adult-Onset Still's Disease
It can be difficult to diagnose Still's disease. That's because Still's has some similarities to other diseases, such as Lyme disease, Crohn's disease, and certain infections. Before confirming your diagnosis, your doctor will need to rule out other problems.
A medical history and physical exam are often the first steps. You may need a variety of blood tests to check for inflammation, changes in blood cell counts, iron levels, and liver enzymes, for example. Imaging tests check for inflammation or enlargement of certain organs.
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.