May 30, 2016
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Still's Disease (cont.)

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What causes Still's disease?

There have been a number of schools of thought regarding the cause (or causes) of Still's disease. One concept is that Still's disease is due to infection with a microbe. Another idea is that Still's disease is an autoimmune disorder. In fact, the precise cause of Still's disease is not yet known.

What are risk factors for Still's disease?

There are no specific known risk factors for the development of Still's disease.

How does Still's disease relate to juvenile idiopathic arthritis?

Still's disease is one type of juvenile idiopathic arthritis (JIA) and is also known as systemic-onset JIA. It is referred to as "juvenile" because it typically affects children under 16 years of age. By systemic, it is meant that along with joint inflammation it typically begins with symptoms and signs of systemic (body-wide) illness, such as high fevers, gland swelling, and internal organ involvement. By idiopathic, it is meant that the disease has no known cause. Systemic-onset JIA was formerly known as systemic-onset juvenile rheumatoid arthritis (JRA) and is the same disease. Several years ago, the naming system for all types of JRA changed, and JRA is now called juvenile idiopathic arthritis or JIA.

What are Still's disease symptoms and signs?

Still's disease usually begins with systemic (body-wide) symptoms. Extreme fatigue can accompany waves of high fevers that rise daily to 102 F (39 C) or even higher and rapidly return to normal levels or below. Fever spikes often occur at approximately the same time every day. A faint salmon-colored skin rash characteristically comes and goes and does not itch.

Poor appetite, nausea, and weight loss are common. There is also commonly swelling of the lymph glands, enlargement of the spleen and liver, and sore throat. Some patients develop inflammation around the heart (pericarditis) and lungs (pleuritis), with occasional fluid accumulation around heart (pericardial effusion) and lungs (pleural effusion). Arthritis, with joint swelling, often occurs after rash and fevers have been present for some time. Although the arthritis may initially be overlooked because of the impressive nature of the systemic symptoms, everyone with Still's disease eventually develops joint pain and swollen joints. This usually involves many joints (polyarticular arthritis). Any joint can be affected, although there are preferential patterns of joint involvement in Still's disease.

Medically Reviewed by a Doctor on 12/8/2015



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