Adult-Onset Still’s Disease

Adult-onset Still’s disease is a form of juvenile idiopathic arthritis (juvenile Still’s disease). But this type affects adults, not kids, and changes how your immune system works.

Your immune system usually protects your body. But with AOSD, your immune system can attack healthy tissue, causing inflammation and organ damage. Over time, the damage can spread to joints and organs throughout your body.

Adult-onset Still’s disease can affect your spleen, liver, heart and lungs. It can also cause your joints to break down. Sometimes, you might have one flare-up that could last a year or more before it goes away. It could come back later — more than once. Or it might become a chronic (ongoing) condition.

And because AOSD’s broad symptoms are similar to more common conditions, it’s not always easy to diagnose. But our experienced specialists know what to look for, so they can put the puzzle pieces together and get you on the road to relief

What to expect at your first visit

It’s important that your providers understand what’s been going on. That’s why your first visit begins with a conversation. We may ask things like:

• When did you first start noticing things weren’t right?
• What kind of symptoms are you having?
• How long have you had them?
• Are they getting worse?
• How have they started to affect your life?
• Have you ever been diagnosed with other autoimmune or autoinflammatory conditions?
• Has anyone else in your family had a similar diagnosis or symptoms?

Testing for adult-onset Still’s disease

No single test can identify adult-onset Still’s disease. So your provider may order several different ones to confirm a diagnosis and to rule out other conditions that cause similar symptoms.

Our team will check your blood and urine (pee) for signs of inflammation and infection in your body. We may also test the fluid inside your joints to learn more about the cause of your joint pain.

We might do imaging tests to see if there’s inflammation in your joints, chest, heart, lungs and other organs:

• CT scan.
• X-ray.
• Ultrasound.
• MRI.
• Echocardiogram.

Meet Our Adult-Onset Still’s Disease Team

A personalized team of healthcare providers from different specialties will care for you at Cleveland Clinic. We choose these providers based on your needs and health. Everyone on your team works together, usually led by our expert rheumatologists, to plan care that focuses on you and your diagnosis. Your team could also include:

• Radiologists.
• Physical therapists.
• Occupational therapists.
• Cardiologists.
• Pulmonologists.
• Gastroenterologists.
• Nurse practitioners.
• Physician assistants.

Whether you’ve had just one bout of adult-onset Still’s disease or have ongoing symptoms, we’re here to help you manage your condition so you can lead a healthy, active life. We use what we learn from your first visit and your test results to decide what treatments will work best for you.

We focus treatment on reducing pain and inflammation, improving how your joints work and preventing complications. Your provider may recommend:

Anti-inflammatory medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil^®or Motrin^®) or aspirin may be the first course of action. We may also prescribe corticosteroids. Both kinds of medications help reduce fever, pain and inflammation.

Immunosuppressive drugs

We offer advanced disease-modifying antirheumatic drugs (DMARDs) to manage severe and chronic adult-onset Still’s disease. DMARDs work by suppressing your immune system. Your providers will figure out which medication can help protect your organs by controlling your immune system to reduce inflammation.

Physical and occupational therapy

Our physical therapists guide you through a personalized exercise routine designed to strengthen your joints. This will help relieve severe joint pain and prevent further damage and inflammation. Our occupational therapists help you learn ways to make everyday tasks easier and less painful to do.

Taking the Next Step

Adult-onset Still’s disease affects everyone differently. After your first flare-up, you many never have it again. Maybe it will show up every now and then. Or maybe you’ll have joint pain and inflammation that’s always there. No matter what you experience with this condition, our healthcare providers will keep an eye on your health over time. You can rely on us to provide the immediate care and long-term follow-up you need. Together, we’ll craft a treatment plan that’ll relieve your pain so you can lead a healthy, active life.