Still's Disease (Systemic-Onset Juvenile Idiopathic Arthritis)

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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Is it possible to prevent Still's disease?

There is no prevention for Still's disease.

What types of specialists treat Still's disease?

Still's disease is treated by primary-care physicians, including pediatricians, internists, general practice, and family practice physicians. Typically, these primary-care doctors work with either pediatric or adult rheumatologists in caring for these patients. Depending on organs affected, other specialists who can be involved in the care of patients with Still's disease include cardiologists, pulmonologists, orthopedic surgeons, physical therapists, and occupational therapists.

What Still's disease research is being done?

A wide variety of research is ongoing related to Still's disease. While intravenous immunoglobulin therapy has been used in adult-onset Still's disease, more studies are needed to confirm these results.

Newer IL-1 blockers may prove to be even more effective in treating Still's disease.

Also, TNF-inhibitors (etanercept [Enbrel] and infliximab [Remicade]) have been used successfully in people who have failed other treatments (much as they are now used in rheumatoid arthritis). The intravenous infusions of infliximab helped decrease the Still's disease signs and symptoms, including fever, arthritis, muscle pains, enlarged spleen, and rash in some studies.

What is the prognosis of Still's disease?

The fever and other systemic features tend to run their course within several months. The arthritis can be a long-term problem. It usually stays on after the systemic features have gone. The arthritis can then become chronic and persist into adulthood. Persisting arthritis of the wrists, with eventual fusion, is common, especially if not treated aggressively. Newer biologic treatments are likely to be beneficial in stopping the progressive joint damage.

REFERENCES:

Klippel, J.H., et al. Primer on the Rheumatic Diseases. New York: Springer, 2008.

Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.

Ruddy, Shaun, et al., eds. Kelley's Textbook of Rheumatology. Philadelphia: W.B. Saunders Co., 2000.

Medically Reviewed by a Doctor on 12/8/2015

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