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Adult-onset Still’s disease (AOSD)

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Rheumatology Network Editorial Staff

July 3, 2019

Adult-onset Still’s disease (AOSD)

Adult-onset Still disease (AOSD) is a rare multisystem inflammatory disorder seen in young adults, typically before the age of 30, and occurring more commonly in women than men. The etiology of AOSD is currently unknown but hypothesized to be autoinflammatory with a component of genetic susceptibility. The disease shares only some of the signs and symptoms of pediatric Still disease (systemic-onset juvenile rheumatoid arthritis) and has many unique clinical features.

AOSD is characterized by spiking fevers that typically peak in the late afternoon or early evening, a pink or salmon-colored evanescent rash, polyarthralgia, hepatosplenomegaly, lymphadenopathy, and sore throat. Fever, rash, and arthralgias occur in most patients. Arthralgias and arthritis typically affect the knees, ankles, and wrists.

There are 3 different patterns in the clinical evolution of AOSD. The monocyclic pattern is self-limited and characterized by one flare of variable duration followed by complete remission. The polycyclic pattern is marked by 2 or more episodes with intervening symptom-free periods. The chronic articular pattern is characterized by severe joint manifestations that lead to joint-space narrowing and destruction. AOSD can also have serious systemic complications including serositis, chronic arthropathy, and macrophage activation syndrome. Late carpal ankylosis occurs in approximately 25% of patients and represents a distinct clinical feature differentiating AOSD from rheumatoid arthritis.

Source: rheumatologynetwork.com/ima...

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Stills

Joining as I was diagnosed with AOSD aged 17 in 1979 at (new) Addenbrookes. I’m looking to connect with others as I’m unwell and suspect Stills involvement.

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lupus-support1Administrator in reply to Stills

I am so very sorry to read this. My advice would be to go to your GP and ask for a referral to see a consultant rheumatologist as soon as possible.

Hope this is of some help.

nras.org.uk/resource/what-i...

arthritis.org/diseases/adul...

rarediseases.org/organizati...

aiarthritis.org/stillsdisease

With good wishes,

Ros

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Stills

Thank you, you are right of course, I’ve self medicated for years but now I’m older (61 and post menopause ) I know I need a holding dose of medication to keep it at bay. The symptoms have been getting noticeably worse these last couple of years…. during the pandemic….. enough said but I am fully vaccinated. Symptoms overlap with so many other conditions that HU has been a vital resource to me but there’s no getting away from it …. I need to see a rheumatologist and get medicine , I wish GP would just write a script for steroids so I see the results and go from there,

Chances of seeing GP - zero

Chances of speaking to GP - 50/50

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lupus-support1Administrator in reply to Stills

Good luck but don’t give up!

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Stills in reply to lupus-support1

Thank you for the support, the new ‘super’ hospital that’s in my city has three rheumatologists listed.

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lupus-support1Administrator in reply to Stills

Fantastic! Be well!