Adult Still disease

Diagnosis

No single test can diagnose adult Still disease. Symptoms can be used to help make a diagnosis. Imaging tests may show joint and organ injury that the disease can cause. In people who have adult Still disease, blood tests may show high levels of some markers of inflammation, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), also called sed rate. Blood tests also can help rule out other conditions that have similar symptoms, such as infections, cancers and other autoimmune conditions.

Treatment

A variety of medicines are used to treat adult Still disease. The type of medicine depends on how serious the symptoms are and possible side effects.

• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), may help with mild joint pain and swelling. Stronger NSAIDs are available by prescription. Because NSAIDs may harm the liver, you might need blood tests to check liver function on a regular basis.
• Corticosteroids. Many people who have adult Still disease need treatment with a corticosteroid, such as prednisone. These powerful medicines ease inflammation. But they may lower the body's resistance to infections, raise the risk of diabetes and lead to weak, brittle bones, a condition called osteoporosis.
• Methotrexate (Jylamvo, Trexall, Xatmep, others). The medicine methotrexate may be used along with prednisone. The prednisone dose typically is lowered when it's used with methotrexate.
• Biologic response modifiers. If other medicines haven't worked, your healthcare professional may suggest that you take a biologic response modifier. These are medicines that block proteins that cause inflammation. They often are called biologics. Some biologics used to treat adult Still disease include:
  • Adalimumab (Humira)
  • Anakinra (Kineret)
  • Canakinumab (Ilaris)
  • Etanercept (Enbrel)
  • Infliximab (Remicade)
  • Rilonacept (Arcalyst)
  • Tocilizumab (Actemra)

Lifestyle and home remedies

If you have adult Still disease, these steps can help keep you healthy:

• Take your medicines. Even if you don't have symptoms every day, it's important to always follow your healthcare professional's directions for taking your medicines. Doing so will help manage inflammation, and that lowers the risk of developing other health issues.
• Keep moving. You might not want to work out if your joints ache. But exercise can help you keep your range of motion and ease pain and stiffness.
• Ask about calcium and vitamin D. If you take a corticosteroid medicine, such as prednisone, talk with a member of your healthcare team about taking calcium and vitamin D supplements. They may help prevent osteoporosis, a disease that weakens bones.

Preparing for your appointment

You're likely to start by seeing your primary healthcare professional. But you might be referred to a doctor who is trained to treat joint diseases, called a rheumatologist. Here are some tips to get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do before your appointment, such as not eating or drinking for a certain amount of time. Make a list of:

• Your symptoms, including any that don't seem related to the reason for your appointment.
• Key personal information, including major stresses, recent life changes and family medical history.
• All medicines, vitamins and other supplements you take, including the doses.
• Questions to ask your healthcare professional.

Take a family member, friend or another trusted person with you, if possible, to help you remember the information you're given.

For adult Still disease, basic questions to ask your healthcare professional include:

• What's likely causing my symptoms?
• What are other possible causes?
• What tests do I need?
• Is my condition likely short-term or long-lasting?
• What's the best course of action?
• What are the alternatives to the approach you're suggesting?
• I have other health conditions. How can I best manage them together?
• Are there things I should or shouldn't do?
• Should I see a specialist?
• Are there brochures or other printed material I can have? What websites do you recommend?

Be sure to ask any other questions you may have.

What to expect from your doctor

Your healthcare professional is likely to ask you questions, such as:

• When did your symptoms start?
• Are your symptoms always present, or do they come and go?
• When are your symptoms most likely to flare?
• What, if anything, makes your symptoms better?
• What, if anything, makes your symptoms worse?
• Have you tried any treatments or self-care measures? Have any of them helped?
• Have you been diagnosed with any other medical conditions?