Symptoms & Signs
Almost all patients will have fever, joint pain, sore throat, and a rash.
* Joint pain, warmth, and swelling are common. Usually, several joints are involved at the same time. Often, patients have morning stiffness of joints that lasts for several hours.
* The fever usually comes on quickly once per day, most commonly in the afternoon or evening.
* The skin rash is typically salmon-pink colored and comes and goes with the fever.
Additional symptoms include:
* Abdominal pain and swelling
* Pain with a deep breath (pleurisy)
* Sore throat
* Swollen lymph nodes (glands)
* Weight loss
Occasionally, the spleen or liver may become swollen. Lung and heart inflammation may occur.
Diagnosis & Tests
Adult Still’s disease can only be diagnosed after other diseases are ruled out. You may need many medical tests before a final diagnosis is made.
A physical exam may reveal a fever, rash, and arthritis. The health care provider will use a stethoscope to listen for changes in the sound of the heart or lungs.
The following blood tests can be helpful in diagnosing adult Still’s disease.
* Complete blood count (CBC) may show a high number of white blood cells and reduced number of red blood cells.
* C-reactive protein (CRP), a measure of inflammation, will be higher than normal.
* ESR (sedimentation rate), a measure of inflammation, will be higher than normal.
* Ferritin level will be very high.
* Fibrinogen level will be high.
* Liver function tests will show high levels of AST and ALT.
* Rheumatoid factor and ANA test will be negative.
Other tests may be needed to check for inflammation of the joints, chest, liver, and spleen.
* Abdominal ultrasound
* CT scan of the abdomen
* X-rays of the joints, chest, or stomach area (abdomen)
Reviewed By : Mark James Borigini, MD, Rheumatologist in the Washington, DC Metro area. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.