Adult Still's disease is a rare type of inflammatory arthritis that features fevers, rash and joint pain. Some people have just one episode of adult Still's disease. In other people, the condition persists or recurs. This inflammation can destroy affected joints, particularly the wrists.

1. ADULT STILL’S DISEASE
BY- SUSHREE SWETALINA
GROUP- 25, 5TH COURSE

2. Adult-onsetStill's disease(AOSD)isanacutesystemic
inflammatorydiseasewithhighlyheterogeneous
clinical manifestations andoutcomesandisconsidered
aspecific clinical formofrheumatoidarthritis.
AOSDisreportedinall thecountries,twoagepeaks
havebeenobserved:16-25yearsand36-46years.
Womengetthediseasesomewhatmoreoftenthanmen.

3.  Itisararesystemicinflammatorydiseasecharacterizedbythe
classictriad:
persistenthighspiking fevers
jointpain
distinctivesalmon-coloredbumpyrash.
 The disease is considered a diagnosis of exclusion.
 There are no specific known risk factors for the
development of STILL’S DISEASE as well as no known
preventive measures.

4. SALMONPINK RASH

5. The etiology of AOSD is still unclear, while there
is evidence that various mechanisms contribute
to the pathogenesis of AOSD, mainly including
genetic susceptibility, infectious triggers,
activation of inflammation( cytokine storm), and
deficient resolution of inflammation.

7. AOSDdiagnosticcriteria
Major criteria:
1. Short-term fever ≥39 °C
2. Arthralgia
3. Transient erythema
4. Pharyngitis
5. Granulocytosis ≥80 %
6. Glycosylated ferritin ≤20 %

8. Minor criteria:
1.Maculopapularrash
2.WBC>10*109/l
Meetingfourormoremajorcriteriaorthree major
andtwominorcriteriaisneeded.

10. DIFFERENTIALDIAGNOSIS
INFECTIOUS : Mycoplasma, Borrelia, Yersinia
MALIGNANT HEMOPATHIES
SYSTEMIC DISEASES : Mevalonate kinase
deficiency , Schnitzler

11. TREATMENT

12. MILDDISEASE: NSAIDS+/-PREDNISOLONE
ACUTEMODERATE-SEVERE DISEASE:
1st line–ANAKINRA
2nd line- STEROIDS
MACROPHAGEACTIVATIONSYNDROME:
ANAKINRA+STEROIDS

13. PROGNOSIS
ITDEPENDSONTHEPHASEOFDISEASE.
 MONOPHASIC:diseaselastsweeks-months(doesnotreccur)
 POLYPHASIC:Discreteflaresseparatedbycompleteremissions
lastingweeks-years
 CHRONIC:Persistentlyactivedisease
Prominentarticularsymptoms

14. PREDICTORSOFWORSEPROGNOSIS
Erosive polyarthritis during the initial
episode
Involvement of shoulders or hips
Cardiac involvement
Macrophage activation syndrome