Adult Still's disease

Abstract

Still's disease is a systemic rheumatic disease of childhood which may persist into adulthood or may occur de novo in the adult population. It is classically distinguished by high fever, rash, arthritis, sore throat. Other clinical features may include lymphadenopathy, hepatosplenomegaly, pleuritis and pericarditis. Because there are no pathognomonic tests, patients frequently undergo a protracted investigative period. Serum ferritin levels greather than 5 folds of normal and glycosylated ferritin fraction lower than 20% of total ferritin are very specific for this disease. Up to one-third of patients is refractory to standard therapies, including methotrexate. Currently, blockade of tumor necrosis factor promises in the treatment of the disease.