ADULT ONSET STILL'S DISEASE

SUMMARY

1. Occurs primarily in adults in their 20s to 30s; onset after age 60 is unusual.

2. present(s) with a distinctive "evanescent" (means "vanishing" or "disappearing"), macular, salmon-pink rash that coincides with a daily ("quotidian") high, spiking fever and significant leukocytosis (Yamaguchi criteria).

3. Mild oligoarthritis usually develops, some may progress to a destructive polyarthritis with joint fusion (especially the wrists).

4. High serum ferritin level (> 10x normal) is strongly associated with this disease and correlates with severe disease activity.

5. Treat with NSAIDs, steroids and DMARDs (Methotrexate).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].