Still's disease

Jump to: navigation, search
Still's disease
ICD-10 M06.1, M08.2
ICD-9 714.30
DiseasesDB 34295 12430

WikiDoc Resources for Still's disease


Most recent articles on Still's disease

Most cited articles on Still's disease

Review articles on Still's disease

Articles on Still's disease in N Eng J Med, Lancet, BMJ


Powerpoint slides on Still's disease

Images of Still's disease

Photos of Still's disease

Podcasts & MP3s on Still's disease

Videos on Still's disease

Evidence Based Medicine

Cochrane Collaboration on Still's disease

Bandolier on Still's disease

TRIP on Still's disease

Clinical Trials

Ongoing Trials on Still's disease at Clinical

Trial results on Still's disease

Clinical Trials on Still's disease at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Still's disease

NICE Guidance on Still's disease


FDA on Still's disease

CDC on Still's disease


Books on Still's disease


Still's disease in the news

Be alerted to news on Still's disease

News trends on Still's disease


Blogs on Still's disease


Definitions of Still's disease

Patient Resources / Community

Patient resources on Still's disease

Discussion groups on Still's disease

Patient Handouts on Still's disease

Directions to Hospitals Treating Still's disease

Risk calculators and risk factors for Still's disease

Healthcare Provider Resources

Symptoms of Still's disease

Causes & Risk Factors for Still's disease

Diagnostic studies for Still's disease

Treatment of Still's disease

Continuing Medical Education (CME)

CME Programs on Still's disease


Still's disease en Espanol

Still's disease en Francais


Still's disease in the Marketplace

Patents on Still's disease

Experimental / Informatics

List of terms related to Still's disease

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and Keywords: Still disease, juvenile-onset; juvenile rheumatoid arthritis; Still disease, adult-onset


Still's disease is a form of juvenile idiopathic arthritis, characterized by high spiking fevers and transient rashes, named after the English physician Sir George Frederic Still (1861-1941). The disease was first discovered in children, but now it is also known to occur, less commonly, in adults in whom it is referred to as adult-onset Still's disease (AOSD) described by another english physician, Bywaters on 1971 (the same author is famous for the crush syndrome).

There are several theories about the cause of Still's disease. It has been suggested it may be caused by a microbacterial infection. However, the cause of Still's disease remains unknown. The pathogenesis of the disease is more secure to be autoimmune.


The fever and most of the other symptoms tend to run their course within several months. However, the arthritis can become a long-term problem as a chronic illness persisting into adulthood. In addition, since the disease can present as an acute illness in adulthood, many adult patients with chronic illness from Still's Disease never show signs or symptoms of the disease in childhood, but both initially present with the disease in adulthood and may have persistence of all symptoms through some period of adulthood. The fever and systemic symptoms in these patients may go in remission, leaving arthritis symptoms. Conversely, all signs and symptoms, including arthritis and systemic signs and symptoms, may either remit completely during adulthood, present intermittently in a "flare" type pattern or, less commonly, continue indefinitely during adulthood.


Because the disease presents in many different ways, diagnosis is difficult. It is often a laborious process consisting of the elimination of other diseases. It is diagnosed on a basis of clinical features of the illness, with the results of a number of common tests combined. Persistent arthritis (lasting at least 6 weeks) is frequently a symptom. A rash is frequently visible on the body, and the patients usually suffer from high, spiking fevers. Blood tests frequently indicate elevated white blood cell counts, suggesting there is serious inflammation. Also, low red blood cell counts (anemia) are common. Typically, elevated blood tests indicate in high sedimentation rates, an indicator of inflammation. Other indicators of inflammation may also be elevated, including CRP (c-reactive protein) and ferritin levels. However, the classic blood tests for rheumatoid arthritis and systemic lupus erythematosus are usually negative. A new important marker of AOSD is the glycosylated ferritin: the percentage of this form of the protein is often below the 50% of the total during the flare of the disease and often during the remission phases.

History and Symptoms

Patients with Still's disease usually have systemic symptoms. Usual symptoms include:

  • waves of high fevers that rise to 40°C (104°F) which may be accompanied by extreme fatigue
  • A faint transient non-itching salmon-colored skin rash can also be observed.
  • Flu like pain throughout the body,
  • Muscle pain


de:Juvenile idiopathische Arthritis it:Malattia di Still dell'adulto sv:Stills sjukdom