Still’s Disease FAQ

Still’s Disease FAQs

Frequently asked questions about Still’s Disease

Q: What does AOSD stand for?

A: Adult Onset Still’s Disease. View a list of commonly used acronyms such as JRA, SLE etc.

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Q: What is Still’s disease in our words?

A: Still’s disease is a disease of inflammation. It can effect the joints, tissues, and organs in the person given the diagnosis. Though it is considered to be an extension in some cases of JRA, in the adult it is closest to SLE (Lupus) in symptoms. Like SLE, Still’s usually hits people in their prime of life, between the ages of 18 and 40. Still’s and SLE are both inflammatory arthritis’. Both can effect the joints, tissues, organs in an individual.. Mainly the difference in still’s is the joint destruction, high fevers and some of the lab test may (such as the ferritin in Still’s patients and the ANA, Complement factors in SLE). However, not all with Still’s experience joint destruction. The cause of Still’s is unfortunately unknown. The cause of Rheumatoid Arthritis, and SLE as well as many other forms of auto-immune arthritis is still unknown. There are many theories on the causes and the circumstances associated with the onset of all these.

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Q: How rare is it?

A: Adult-onset Still’s Disease is rare and has been described all over the world. Prevalence is estimated at 1.5 cases per 100,000-1,000,000 population. There is a bi-modal age distribution with one peak incidence between ages 15–25 and a second peak between ages of 36–46 years.

Cited from:

Int J Pharm Bio Sci 2013 Oct; 4(4): (B) 694 – 697
This article can be downloaded from
B – 694
Case Report Gynaecology
International Journal of Pharma and Bio Sciences ISSN


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Q: Why are people affected differently and How? with rash or fever etc…?

A: It is unknown why people respond to medications differently and why people effected with Still’s experience an assortment of symptoms. Given time, one may experience the same symptoms as another person. Some people are closely the same in their symptoms and others vary from week to week and month to month. Others may experience much the same symptoms as others, just not at the same time or course of the disease. Some joint destruction can also be associated with medication use, as well as organ destruction. Steroids (though the known life saver of acute flare ups of the disease) can lead to many complications such as joint destruction, diabetes, and others. The rash has been studied and is a salmon colored rash appearing on the upper anterior torso, upper arms and upper legs, thighs. The rash also usually does not itch. (The International Still’s Disease Foundation sponsors several support groups and it’s Still’s disease patient members report varying experiences. Many report extreme itching with their rashes.)

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Q: Does it last forever?

A: Studies have shown that Still’s does go away after a ten year time frame in 35-40% of those that have been given the diagnosis. The fortunate are in this small percentage. There are at times re-missive type episodes in which some people ( not all ) may experience one month to one year or more of either a lesser degree of symptoms or in the rarest of cases, some are completely symptom free; however, this usually occurs early on in the course of the disease. As the person with Still’s ages along with the longevity of the disease, the symptoms often come on harder and do not respond to medications as they had in the past. At times the inflammation gets to a point where the medication that one has been taking seems to no longer work. Meaning the inflammatory response of the disease is greater than the effect of the medication.

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Q: What medications are used to treat Still’s disease?

A: Medications are often given as a secondary line of medications for those with  Arthritis in general. There are a few small current studies done on Still’s disease and these are mainly with the anti-tnf, or anti-il drugs or biologics. If a person with still’s does partake in a study, it is usually grouped with other forms of arthritis. Medications vary from Steroids, NSAIDS, Cox-2 inhibitors, and Dmards, to medications that protect one part of the body from the effects of the medication that is helping to control the inflammatory response. Many people are often on several different medications at one time. As still’s disease also can affect the organs; some people require heart and lung medication as well as diabetic medications. Pain medication in most cases is also necessary. In the early years, pain medication may be used with the on and off type episodes of the disease.

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Q: What is remission? And what are the different kinds?

A) According to a standard DAS Board of rheumatology the criteria for remission is:

Absence of active disease activity for preceding 3 months of:

  1. Normal ranges of blood work
  2. No joint inflammation
  3. No fevers
  4. No morning stiffness
  5. No fatigue

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Q: How can family members and friends try to understand?

A: Become educated. Listen. Go to appointments with the patient if possible. Let the patient talk about their lives with the illness. Understand things can change at a moments notice from day to day. Find a support group.

The International Still’s Disease Foundation offers FREE Informational Brochures. We will mail them worldwide at no charge. To request copies use the box on the left of your screen and we will be happy to send you or anyone requesting them.

You may also use our site to join in our weekly hosted Chat hours, use our discussion board or join one of our sponsored support groups to meet and share your experiences with others.

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Q: Is JRA and Still’s the same only that Still’s is more common in Adults?

A: It is a theory that JRA and Still’s are the same. However, it is still unknown. Some people with JRA get better and never have symptoms again. Some with JRA experience a return of symptoms later in life. It is also unknown if an adult that develops Still’s at a later age might have actually had some symptoms of JRA as a child and these symptoms might have been overlooked or thought to be something else. As our medical world is advancing every day and just as new medications are developed, new disease are discovered. Some of those have been diseases which were at one time thought to be a part of something else or something else all together.

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IFAA & the National Data Bank for Rheumatic Diseases have joined forces to further Still's research. Join now!



History - Manifestations
Diagnoses - Management

Presented By
Dr. John J. Cush