Adult-onset Still's disease history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

Obtaining a comprehensive history is an integral part of diagnosing adult-onset Still’s disease (AOSD). The typical age of onset of adult-onset Still’s disease (AOSD) is between 16 to 35 years of age. A patient suffering from AOSD may present with a fever greater than equal to 39 degrees celcius (102.2 degrees Fahrenheit) for greater than equal to 1 week along with associated arthralgia/arthritis for greater than equal to 2 weeks. There may be a maculopapular non-pruritic rash on the trunk or limbs. Patients may also complain of sore throat and lymphadenopathy. The symptoms of AOSD evolve over a period of weeks.

History

Obtaining a comprehensive history is an integral part of diagnosing adult-onset Still’s disease (AOSD). The following findings on history may help identify AOSD:^[1]

Age of onset

The typical age of onset of adult-onset Still’s disease (AOSD) is between 16 to 35 years of age.

Family history

Adult onset Still’s disease (AOSD) is not a genetic/hereditary condition but it is known to be associated with various HLA alleles.

Initial presentation

A patient suffering from AOSD may present with a fever greater than equal to 39 degrees celcius for greater than equal to 1 week along with associated arthralgia/arthritis for greater than equal to 2 weeks. There may be a maculopapular non-pruritic rash on the trunk or limbs. Patients may also complain of sore throat and lymphadenopathy. Physicians should rule out other causes of fever and arthralgia for example, septic arthritis, rheumatoid arthritis, drug reaction and malignancy.

Past medical history

The symptoms of AOSD evolve over a period of weeks.

Symptoms

Common symptoms

The common symptoms of AOSD include the following:^[2]^[3]

Spiking fever greater than equal to 39 C for greater than equal to 1 week
Arthralgia for greater than equal to 2 weeks
Maculopapular non-pruritic rash on the trunk or limbs
Sore throat
Lymphadenopathy

Less common symptoms

Less common symptoms of AOSD include the following:^[4]

References

↑ Wouters JM, van de Putte LB (November 1986). “Adult-onset Still’s disease; clinical and laboratory features, treatment and progress of 45 cases”. Q. J. Med. 61 (235): 1055–65. PMID 3659248.
↑ Efthimiou P, Paik PK, Bielory L (May 2006). “Diagnosis and management of adult onset Still’s disease”. Ann. Rheum. Dis. 65 (5): 564–72. doi:10.1136/ard.2005.042143. PMC 1798146. PMID 16219707.
↑ Wouters JM, van de Putte LB (November 1986). “Adult-onset Still’s disease; clinical and laboratory features, treatment and progress of 45 cases”. Q. J. Med. 61 (235): 1055–65. PMID 3659248.
↑ Masson C, Le Loët X, Lioté F, Renou P, Dubost JJ, Boissier MC, Brithmer L, Brégeon C, Audran M (December 1995). “Adult Still’s disease: part I. Manifestations and complications in sixty-five cases in France”. Rev Rhum Engl Ed. 62 (11): 748–57. PMID 8869216.

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[pmid36592482-1] Wouters JM, van de Putte LB (November 1986). “Adult-onset Still’s disease; clinical and laboratory features, treatment and progress of 45 cases”. Q. J. Med. 61 (235): 1055–65. PMID 3659248.

[pmid16219707-2] Efthimiou P, Paik PK, Bielory L (May 2006). “Diagnosis and management of adult onset Still’s disease”. Ann. Rheum. Dis. 65 (5): 564–72. doi:10.1136/ard.2005.042143. PMC 1798146. PMID 16219707.

[pmid3659248-3] Wouters JM, van de Putte LB (November 1986). “Adult-onset Still’s disease; clinical and laboratory features, treatment and progress of 45 cases”. Q. J. Med. 61 (235): 1055–65. PMID 3659248.

[pmid8869216-4] Masson C, Le Loët X, Lioté F, Renou P, Dubost JJ, Boissier MC, Brithmer L, Brégeon C, Audran M (December 1995). “Adult Still’s disease: part I. Manifestations and complications in sixty-five cases in France”. Rev Rhum Engl Ed. 62 (11): 748–57. PMID 8869216.

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