Materiały źródłowe

• #1 Still Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538345/

  Adult-onset Still’s disease (AOSD) is an uncommon systemic inflammatory disorder characterized by inflammatory polyarthritis, daily fever, and a transient salmon-pink maculopapular rash. The management of AOSD underscores the pivotal role of an interprofessional healthcare team in providing comprehensive care for affected individuals. […] This activity emphasizes the management of AOSD and the pivotal role of an interprofessional healthcare team in delivering comprehensive care for individuals affected by this rare systemic inflammatory disorder. […] Coordinate care seamlessly within the healthcare team to optimize patient outcomes, emphasizing the importance of a multidisciplinary approach in treating AOSD. […] Due to the severe joint involvement in AOSD, physical and occupational therapy are essential components of the patient’s rehabilitation regimen.

• #1 Comprehensive Treatment for Still’s Disease in Atlanta

  https://argmd.net/conditions-we-treat/adult-onset-stills-disease/

  Adult-Onset Stills Disease (AOSD) is a rare type of inflammatory arthritis that can affect the entire body. […] Early diagnosis and treatment at Arthritis and Rheumatology of Georgia (ARG) are essential for managing symptoms and preventing complications. […] Medications: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): To relieve pain and reduce inflammation. […] Corticosteroids: To reduce inflammation and control acute flare-ups. […] Disease-Modifying Antirheumatic Drugs (DMARDs): Such as methotrexate to control the immune system. […] Biologic Agents: Such as anakinra, tocilizumab, or etanercept to target specific pathways in the immune response. […] Therapies: Physical Therapy: Exercises to improve joint flexibility and muscle strength. […] Occupational Therapy: Techniques to perform daily activities safely and efficiently.

• #1 Still Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538345/

  As integral members of the healthcare team, nurses play a vital role in monitoring vital signs, administering medications, and alerting clinicians to changes in patient status or lack of progress, contributing significantly to the overall patient care strategy. […] This approach is crucial for early detection, preventing complications, and improving the overall prognosis.

• #1 Adult-onset Still’s disease: Treatment – UpToDate

  https://www.uptodate.com/contents/adult-onset-stills-disease-treatment

  Adult-onset Still’s disease (AOSD) is an inflammatory disorder characterized by quotidian (daily) fevers, arthritis, and an evanescent rash. The treatment and prognosis of AOSD will be reviewed here. The goals of therapy include: Control of the physical signs and symptoms of inflammation (eg, fever, rash, morning stiffness, joint pain, and swelling) and, secondarily, control of laboratory indices of inflammation (eg, elevations in the erythrocyte sedimentation rate [ESR] and levels of C-reactive protein [CRP]). […] The clinical manifestations and diagnosis of AOSD and the treatment of sJIA are presented separately.

• #1 Adult Onset Still’s Disease Presenting with Acute Respiratory Distress Syndrome: Case Report and Review of the Literature

  https://openrheumatologyjournal.com/VOLUME/7/PAGE/125/FULLTEXT/

  Adult-onset Stills disease (AOSD) is a systemic inflammatory disorder characterized by rash, leukocytosis, fevers, and arthralgias. […] It is important to recognize ARDS as a manifestation of AOSD so that proper diagnostic and therapeutic management can be initiated promptly. […] Severe systemic manifestations associated with AOSD include disseminated intravascular coagulation (DIC), macrophage activation syndrome (MAS), and hepatic failure. […] Pulmonary involvement, usually pleuritis, is a recognized manifestation of AOSD. […] A retrospective analysis of 61 patients by Zeng et al. found that 11.5% had interstitial pneumonia on CT. […] The case presented here illustrates the severe presentation of AOSD with ARDS and its response to high dose corticosteroid therapy. […] Early recognition of AOSD can lead to prompt initiation of appropriate therapy.

• #1 Adult Still disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adult-stills-disease/diagnosis-treatment/drc-20351912

  A variety of medicines are used to treat adult Still disease. The type of medicine depends on how bad the symptoms are and possible side effects. […] Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), may help with mild joint pain and inflammation. Stronger NSAIDs are available by prescription. Since NSAIDs can damage the liver, regular blood tests may be needed to check liver function. […] Many people who have adult Still disease require treatment with steroids, such as prednisone. These powerful drugs reduce inflammation. They may lower the body’s resistance to infections and increase the risk of developing osteoporosis and diabetes. […] The medicine methotrexate (Trexall) is often used in combination with prednisone. The prednisone dose is reduced when combined with methotrexate.

• #1 Adult Still disease: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000450.htm

  Adult Still disease (ASD) is a rare illness that causes high fevers, rash, and joint pain. It may lead to long-term (chronic) arthritis. […] The goal of treatment for adult Still disease is to control the symptoms of arthritis. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are most often used first. […] Prednisone may be used for more severe cases. […] If the disease is severe or persists for a long time (becomes chronic), medicines that suppress the immune system might be needed. Such medicines include: Methotrexate, Anakinra (interleukin-1 receptor agonist), Tocilizumab (interleukin 6 inhibitor), Tumor necrosis factor (TNF) antagonists such as etanercept (Enbrel). […] Contact your provider if you have symptoms of adult Still disease. […] If you have already been diagnosed with the condition, you should call your provider if you have a cough or difficulty breathing.

• #1 Hemophagocytic Syndrome in a Patient with Adult-onset Still’s Disease | Volume 26 – Issue 2 – June 2011 | Archives of Rheumatology

  https://archivesofrheumatology.org/full-text/405

  Adult-onset Still’s disease (AOSD) is a systemic inflammatory disease which has unknown etiology and pathology. Non-steroid antiinflammatory drugs (NSAID’s), corticosteroids and disease modifying anti- rheumatic drugs (DMARD’s), especially methotrexate (MTX), are used in the treatment of AOSD. Hemophagocytic syndrome (HS) is a rare potentially fatal disease that shares several clinical and laboratory features including pancytopenia hepatosplenomegaly, elevated liver enzymes, hyperferritinemia and hypertriglyceridemia. Adult-onset Still’s disease seems to be the main underlying systemic disease. Hemophagocytic syndrome shares similar clinical and laboratory features with AOSD. The main differences between the two diseases are cutaneous, articular involvement and different hematological findings. Thrombocytosis and leukocytosis are present in AOSD but pancytopenia is present in HS. The development of cytopenias is an important feature of this syndrome. Non-steroidal antiinflammatory drugs and steroid DMARD’s, are used for the treatment of AOSD. In our case, we made a differential diagnosis between neoplastic diseases especially leukemias, lymphomas, drugs (especially MTX), and infectious diseases that originated from viruses. We finally showed in our patient AOSD triggered HS. […] In conclusion, we think that clinicians must be careful and tolerant in clinic observations with the AOSD patients.

• #1 A Case Report of Still’s Disease in the Adult | Cardoso | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/2847/2179

  Adult Stills disease (ASD) is a rare systemic inflammatory disorder of unknown etiology, typically characterized by a clinical triad (daily spiking high fevers, evanescent rash, and arthritis) and a biological triad (hyperferritinemia, hyperleucocytosis with neutrophilia and abnormal liver function test). […] Treatment options include non-steroid anti-inflammatory drugs (NSAIDs) and aspirin, glucocorticoids, and immunomodulating drugs. Most patients require steroids at some point in the course of their ASD; the usual prednisone dose is 0.5 – 1.0 mg/kg/day. Responses to steroid therapy range from 76% to 95%. […] The treatment generally relies on NSAIDs and steroids, requiring no further more potent immunosuppressors. In some refractory cases, hydroxychloroquine, gold salts, methotrexate and cyclosporine have been used with limited data.

• #1 Management of adult-onset Still’s disease: evidence- and consensus-based recommendations by experts

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11147545/

  Corticosteroids are effective in AOSD but should be avoided because of side effects. […] Early initiation of biologics is preferred over conventional treatment such as methotrexate. […] There is an important role for early use of IL-1 and IL-6 blockade in AOSD. […] Anti-inflammatory drugs form the cornerstone of treatment of AOSD. […] Treatment is often based on expert opinion through the lack of international guidelines. […] Historically, glucocorticoids (GC) are considered the backbone of treatment. […] More recently, IL-1 and IL-6 were identified as important mediators of inflammation in AOSD. […] Biologics targeting these pathways are approved by both the FDA and the EMA for the treatment of sJIA and AOSD. […] The goal remains to limit the use of GC in AOSD, mainly because of the side effects.

• #1 Biological treatment in resistant adult-onset Still’s disease: A single-center, retrospective cohort study | Volume 37 – Issue 1 – March 2022 | Archives of Rheumatology

  https://archivesofrheumatology.org/full-text/1304

  Biological drugs seem to be effective for AOSD patients who are resistant to conventional therapies. Due to the administration methods and the high costs of these drugs, however, tapering the treatment should be considered, after remission is achieved. […] The biological drugs were prescribed to the patients with clinical and laboratory active disease. Before starting a biological drug, all patients received at least one conventional therapy (corticosteroids, methotrexate, leflunomide, and cyclosporine-A). Anakinra (IL-1 inhibitor) and tocilizumab (IL-6 inhibitor) were used as biological therapy depending on the clinical and laboratory findings of the patients. […] In conclusion, in the course of AOSD, biological drugs may be rarely required for patients with active disease and arthritis resistant to conventional therapies. However, many cytokines play a role in the pathogenesis of the disease, inhibition of the main cytokines with biological drugs is crucial. Using IL-1 inhibitors for the improvement of mainly systemic symptoms and using IL-6 inhibitors for the improvement of mainly chronic articular symptoms seem to be rational. Besides, due to both the potential adverse events and the high costs of the drugs, reducing the dose, lengthening the dosing interval, and ceasing the drugs should be the key points to be considered for patients with remission.

• #1 Adult Still’s Disease

  https://www.arthritis.org/diseases/adult-stills-disease

  Adult-onset Stills disease is a rare type of arthritis that is thought to be autoimmune or autoinflammatory. […] Doctors use several drugs to treat adult Still’s disease. Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) help to reduce mild pain and inflammation. […] With adult Stills disease, the medications may need to be taken even after symptoms go away. This is called maintenance therapy. Its important to keep inflammation under control to prevent damage to joints and organs. […] Caring for the body and mind are key components of an adult Still’s disease management plan. Make positive and healthy lifestyle choices and acknowledge the physical and emotional effects of arthritis. Proper nutrition, activity, rest and following doctors’ orders are important for managing the condition and possible medication side-effects.

• #1 Adult Still disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adult-stills-disease/symptoms-causes/syc-20351907

  Adult Still disease can damage joints, particularly the wrists. Treatment involves medicine to reduce pain and help control the disease. Prednisone is often used if pain relievers such as ibuprofen (Advil, Motrin IB, others) are not enough. […] If you have a high fever, rash and achy joints, see your health care provider. Also, if you have adult Still disease and develop a cough, difficulty breathing, chest pain or any other symptoms that are not usual, call your health care provider. […] Adult Still disease inflames the organs and joints. Most complications from the disease result from this inflammation. […] The chronic swelling and irritation that occurs with adult Still disease can damage the joints. The most commonly involved joints are the knees and wrists. Sometimes other joints, including the neck, foot, finger and hip joints, also are affected.

• #1 Adult Still disease | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/adult-still-disease

  If you’re taking high doses of prednisone, talk to your care provider about taking more calcium and vitamin D supplements to help prevent osteoporosis. […] Although you might not want to work out if your joints ache, exercise is recommended for all types of arthritis. Exercise can help you keep your range of motion and relieve pain and stiffness.

• #1 Still’s disease: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/stills-disease

  A person may still need to take these medications even after the symptoms go away. This maintenance therapy can keep inflammation under control and prevent further bone, cartilage, and organ damage. […] People can take steps to help manage the symptoms of AOSD. These steps include: […] Engaging in regular physical activity: Exercising and staying active can help maintain the range of motion of the joints and keep the muscles strong. It can also help a person maintain a moderate weight, reducing strain on the joints. […] Adhering to a healthy eating pattern: Alongside exercise, a nutritious, balanced diet can help control a persons weight, improve energy levels, and reduce fatigue. […] Reducing strain: Using joint protection techniques, pacing activities carefully, and including sufficient breaks in the day can help reduce the strain on joints.

• #1 Adult-onset Still’s disease | Symptoms, treatments and new research

  https://versusarthritis.org/about-arthritis/conditions/adult-onset-still-s-disease/

  NSAIDs will be the first treatment for people who have a mild form of AOSD. […] Steroids will often be given as one of the first treatments for people with AOSD, particularly if the symptoms are severe, as they help to reduce symptoms quickly in many people with the condition. […] Your doctor may refer you to a physiotherapist for advice on exercise and physical activity. […] Keeping as active as you can is important for your joints. […] Learning how to pace yourself and protect your joints can help manage your fatigue and reduce your symptoms. […] If you are stressed or feel down because of your condition and how it is affecting you, this may also make your symptoms feel worse. […] If you’re feeling unwell or fatigued, or have joint pain, sex might be the last thing on your mind. […] You might find working difficult with AOSD, but there are things in place that can support you in your working life.

• #1 Living with an invisible disease | Sobi

  https://www.sobi.com/en/stories/living-invisible-disease

  Vanda has accepted that certain things about her health would not be under her control. […] Instead, she chose to do everything she could to help get better physically, which helped with her mental healing too. […] After she was diagnosed with AOSD, Vanda says she felt relieved, but then went through a period of grieving, a true rollercoaster both physically and emotionally. […] I would encourage anyone newly diagnosed with Stills disease to seek out support from Stills disease social media groups, to connect with those of us online supporting each other. […] Although her journey has been challenging, Vanda says that learning and sharing with others in the Stills community empowers her to live better with her condition. […] Vanda has committed to becoming an advocate for further research to understand what causes Stills disease and the treatment options available. […] From her experience, Vanda believes that just speaking with others who understand can be healing.

• #1 Anyone out there with Adult Onset Still’s Disease? – Page 6 — Versus Arthritis

  https://community.versusarthritis.org/discussion/23425/anyone-out-there-with-adult-onset-stills-disease

  I understand that you have had a diagnosis of Adult-Onset Still’s Disease (AOSD) from the age of 27. You are finding life very difficult and are taking a lot of medication to treat the disease. […] Our web site has a great page of information on AOSD, which includes information on treatments, managing your symptoms and living with Adult-Onset Still’s Disease. […] One thing I can’t stress enough is don’t neglect your mental health. The disease you will fully recover from, in a few more years. The mental health problems, you never recover from. […] It sounds bizarre, but take your mental health even more seriously than you are taking the disease. The disease, you will recover from. Whether it’s 18 months or 5 years. It’s inevitable. […] I’m sorry to hear of everything you are experiencing with your recent diagnosis of Adult onset stills disease, AOSD, this must be really tough for you, but hopefully you will get more information at your Rheumatology appt next week. […] You can also find lots of useful information on our Versus Arthritis website including how you can manage pain and the treatments available for people with different kinds of arthritis.

• #1 A CASE OF ADULT ONSET STILL DISEASE – SHM Abstracts | Society of Hospital Medicine

  https://shmabstracts.org/abstract/a-case-of-adult-onset-still-disease/

  AOSD is a rare inflammatory disorder of unknown etiology that has been used to describe features of systemic Juvenile Inflammatory Arthritis occurring in patients older than 16 years. […] Therapy goals of treating AOSD include controlling inflammation and preventing end-organ damage and complications, such as hepatitis and joint destruction. […] This case presentation highlights the complexity of identification and diagnosis of Adult Onset Still Disease.

• #1 Adult Onset Still’s Disease: A Retrospective Study of Objective Manifestations and Outcomes – ACR Meeting Abstracts

  https://acrabstracts.org/abstract/adult-onset-stills-disease-a-retrospective-study-of-objective-manifestations-and-outcomes/

  Adult Onset Stills Disease (AOSD) is a complex and rare inflammatory disease with life threatening complications. […] We identified 185 patients with AOSD with an incidence rate of 0.16 to 0.21 per 100,000. […] Nearly 24% of patients required ICU level of care and overall mortality rate was 3.2%. […] Our study establishes patient demographics and common objective findings to better understand and diagnose this rare disease. […] Objective data also further solidified known lab abnormalities in this group including elevated inflammatory markers, leukocytosis, and anemia. […] Prior studies have suggested that concomitant pneumonia caused greater severity of disease with increased mortality. This differed in our population, although our study was limited by lack of follow-up data. Further studies may analyze patients who fit Yamaguchi criteria as well as complications and long term outcomes.

• #1 Management of Adult-Onset Still’s Disease Patients in Intensive Care Unit: a Case Report | Andriani | JAI (Jurnal Anestesiologi Indonesia)

  https://ejournal.undip.ac.id/index.php/janesti/article/view/65781

  Adult-onset Still’s disease (AOSD) is a rare inflammatory disorder characterized by the classic triad of fever, arthritis, and evanescent rash. […] Management of such conditions in the intensive care unit (ICU) is crucial. […] The first-line therapy given was methylprednisolone, doses were tapered gradually. As the patient didn’t respond to therapy, she was then given immunosuppressive therapies such as cyclosporine, hydroxychloroquine and underwent therapeutic plasma exchange (TPE). […] Making a correct diagnosis and starting an appropriate treatment as soon as feasible is crucial in this case as the patient suffers complications.

• #1 Clinical characteristics and treatment of elderly onset adult-onset Still’s disease | Scientific Reports

  https://www.nature.com/articles/s41598-022-10932-3

  Adult-onset Stills disease (AOSD) is a systemic inflammatory disease characterized by spiking fever, transient rash, and polyarthritis. […] Elderly AOSD is not uncommon; these patients have different characteristics than younger-onset patients. Devising a way to control disease activity quickly while managing infections may be an important goal in elderly AOSD. […] The treatment of AOSD has progressed recently, and immunosuppressants, including methotrexate or cyclosporine and targeting therapy, such as IL-1 or IL-6 inhibitors, are available in addition to glucocorticoids (GCs). […] In elderly patients, a delay in adequate treatment can easily lead to a decline in activities of daily living. […] The appropriate use of immunosuppressive agents, including cytokine inhibitors, may be necessary for the rapid control of disease activity and early reduction of GC dose.

• #1 Managing adult-onset Still’s disease in pregnancy: A case report

  https://www.wjgnet.com/2307-8960/full/v12/i16/2837.htm

  AOSD can significantly impact pregnancy and childbirth, as it may become more severe during pregnancy, with an increased risk of fetal loss and preterm birth. […] The management of AOSD during pregnancy involves the use of nonsteroidal anti-inflammatory drugs and glucocorticoids, as well as immunosuppressive agents in severe cases. […] Women with AOSD who are considering pregnancy should discuss their options with their healthcare provider and develop a management plan that addresses the potential risks to both mother and fetus. […] AOSD can have significant implications for pregnancy and childbirth, including an increased risk of fetal loss and preterm birth. […] Therefore, close monitoring and management of AOSD during pregnancy is essential to ensure the best possible outcome for mother and child. […] The hereditary implications of AOSD are not well understood; however, evidence suggests that genetic factors may play a role in disease development. […] Neonatal HLH can be a complication of AOSD in pregnancy and requires prompt diagnosis and management.

• #1 Adult Still’s disease and nursing care: a case report – Medical Journal of Bakirkoy

  https://bakirkoymedj.org/articles/doi/BTDMJB.20141107091127

  Adult Still’s Disease (ESD) is a systemic inflammatory disease, first reported by Bywaters in 1971, with the same clinical and laboratory features as the acute systemic onset form of juvenile chronic arthritis. The classic symptoms of the disease are fever, arthritis and typical skin rashes, which are seen in older than 16 years. It is typical of fever rising to 40°C once or twice a day, often in the morning and evening hours. But subfebrile fever can also be occur during the day. Skin findings are maculopapular, usually seen in the evening hours when the fever is high, disappear quickly and reappear elsewhere the next day. It is most commonly seen in the body and proximal parts of the extremities, more rarely in the neck and in the face. Arthralgia is seen in almost every case, and arthritis occurs in 94% of patients. […] This case report has been prepared for the represent a patient who diagnosed rare “Adult Still’s disease” and followed in internal medicine clinic, for the purpose of the determining of nursing diagnosis and nursing care plan according to the model of “Daily Life Activities”.

• #1 Adult-Onset Still Disease – What You Need to Know

  https://www.drugs.com/cg/adult-onset-still-disease.html

  AOSD cannot be cured or prevented. Treatment focuses on slowing the progression of AOSD and preventing or managing flares. […] The following may be used to help control symptoms of AOSD: […] Rest as needed. You may feel more tired than usual. Try not to do too much during the day. […] Manage stress. Stress is the main trigger for AOSD flares. […] Apply ice. Ice helps relieve joint pain and reduces swelling. […] Apply heat. Heat helps relieve joint and muscle pain. […] Be physically active, as directed. Physical activity, such as exercise, may help your joints feel less stiff. […] Keep taking your medicine, even if you feel better. AOSD flares come and go. […] You have the right to help plan your care. Learn about your health condition and how it may be treated.

• #1 Comprehensive Treatment for Still’s Disease in Atlanta

  https://argmd.net/conditions-we-treat/adult-onset-stills-disease/

  Symptom Management: Using medications, therapies, and lifestyle changes to manage symptoms and reduce flare-ups. […] Regular Check-Ups: Keeping up with appointments to monitor disease progression and treatment efficacy. […] Support Systems: Seeking support from family, friends, or support groups to manage the emotional impact of living with a chronic disease. […] Education: Learning about the condition and staying informed about new treatments and management strategies. […] At Arthritis and Rheumatology of Georgia, we offer comprehensive care for AOSD, including diagnostic tests, personalized treatment plans, and ongoing management to reduce inflammation and improve quality of life.

• #1 Adult Still disease | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/adult-still-disease

  Adult Still disease can damage joints, particularly the wrists. Treatment involves medicine to reduce pain and help control the disease. Prednisone is often used if pain relievers such as ibuprofen (Advil, Motrin IB, others) are not enough. […] A variety of medicines are used to treat adult Still disease. The type of medicine depends on how bad the symptoms are and possible side effects. […] Many people who have adult Still disease require treatment with steroids, such as prednisone. These powerful drugs reduce inflammation. They may lower the body’s resistance to infections and increase the risk of developing osteoporosis and diabetes. […] Even if you have no symptoms some days, it’s important to take your medicines as your care provider recommends. Controlling inflammation helps reduce the risk of complications.

• #2 Adult Still’s disease and nursing care: a case report – Medical Journal of Bakirkoy

  https://bakirkoymedj.org/articles/doi/BTDMJB.20141107091127

  Adult Still’s Disease (ESD) is a systemic inflammatory disease, first reported by Bywaters in 1971, with the same clinical and laboratory features as the acute systemic onset form of juvenile chronic arthritis. The classic symptoms of the disease are fever, arthritis and typical skin rashes, which are seen in older than 16 years. It is typical of fever rising to 40°C once or twice a day, often in the morning and evening hours. But subfebrile fever can also be occur during the day. Skin findings are maculopapular, usually seen in the evening hours when the fever is high, disappear quickly and reappear elsewhere the next day. It is most commonly seen in the body and proximal parts of the extremities, more rarely in the neck and in the face. Arthralgia is seen in almost every case, and arthritis occurs in 94% of patients. […] This case report has been prepared for the represent a patient who diagnosed rare “Adult Still’s disease” and followed in internal medicine clinic, for the purpose of the determining of nursing diagnosis and nursing care plan according to the model of “Daily Life Activities”.

• #2 Exploring Best Practices for Diagnosis and Management of Adult-Onset Still’s Disease

  https://www.mycme.com/courses/exploring-best-practices-for-diagnosis-and-management-of-adult-onset-stills-disease-7798

  Adult-onset Still’s disease (AOSD) is a rare, polygenic autoinflammatory syndrome with a pathogenesis similar to systemic juvenile inflammatory arthritis. […] This activity was developed for a national audience of rheumatologists, rheumatology advanced practice providers, dermatologists, primary care physicians, and other clinicians involved in the care of patients with adult-onset Still’s disease. […] Upon completion of this activity, participants should be better able to: Describe the optimal pathway of diagnosis for a patient presenting with possible adult-onset Still’s disease (AOSD), using resources available in the average clinical setting. […] Develop a personalized treatment strategy for AOSD, taking into consideration a patient’s subtype and risk assessment for systemic complications. […] Describe the mechanism of action, safety, and efficacy of new and emerging biologic treatments for AOSD. […] Consider patient HRQoL as part of an AOSD treatment monitoring protocol.

• #2 Get Adult-Onset Still’s Disease Care | Cleveland Clinic

  https://my.clevelandclinic.org/services/adult-onset-stills-disease-treatment

  Finding healthcare providers familiar with diagnosing and treating this condition is important. Our skilled rheumatology providers recognize and treat AOSD with personalized, expert care. […] We focus treatment on reducing pain and inflammation, improving how your joints work and preventing complications. Your provider may recommend: […] 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. […] 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.

• #2 Still Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538345/

  As integral members of the healthcare team, nurses play a vital role in monitoring vital signs, administering medications, and alerting clinicians to changes in patient status or lack of progress, contributing significantly to the overall patient care strategy. […] This approach is crucial for early detection, preventing complications, and improving the overall prognosis.

• #2 Hemophagocytic Syndrome in a Patient with Adult-onset Still’s Disease | Volume 26 – Issue 2 – June 2011 | Archives of Rheumatology

  https://archivesofrheumatology.org/full-text/405

  Adult-onset Still’s disease (AOSD) is a systemic inflammatory disease which has unknown etiology and pathology. Non-steroid antiinflammatory drugs (NSAID’s), corticosteroids and disease modifying anti- rheumatic drugs (DMARD’s), especially methotrexate (MTX), are used in the treatment of AOSD. Hemophagocytic syndrome (HS) is a rare potentially fatal disease that shares several clinical and laboratory features including pancytopenia hepatosplenomegaly, elevated liver enzymes, hyperferritinemia and hypertriglyceridemia. Adult-onset Still’s disease seems to be the main underlying systemic disease. Hemophagocytic syndrome shares similar clinical and laboratory features with AOSD. The main differences between the two diseases are cutaneous, articular involvement and different hematological findings. Thrombocytosis and leukocytosis are present in AOSD but pancytopenia is present in HS. The development of cytopenias is an important feature of this syndrome. Non-steroidal antiinflammatory drugs and steroid DMARD’s, are used for the treatment of AOSD. In our case, we made a differential diagnosis between neoplastic diseases especially leukemias, lymphomas, drugs (especially MTX), and infectious diseases that originated from viruses. We finally showed in our patient AOSD triggered HS. […] In conclusion, we think that clinicians must be careful and tolerant in clinic observations with the AOSD patients.

• #2 Adult-onset Still’s disease | Symptoms, treatments and new research

  https://versusarthritis.org/about-arthritis/conditions/adult-onset-still-s-disease/

  NSAIDs will be the first treatment for people who have a mild form of AOSD. […] Steroids will often be given as one of the first treatments for people with AOSD, particularly if the symptoms are severe, as they help to reduce symptoms quickly in many people with the condition. […] Your doctor may refer you to a physiotherapist for advice on exercise and physical activity. […] Keeping as active as you can is important for your joints. […] Learning how to pace yourself and protect your joints can help manage your fatigue and reduce your symptoms. […] If you are stressed or feel down because of your condition and how it is affecting you, this may also make your symptoms feel worse. […] If you’re feeling unwell or fatigued, or have joint pain, sex might be the last thing on your mind. […] You might find working difficult with AOSD, but there are things in place that can support you in your working life.

• #2 ADULT ONSET STILL’S DISEASE | Comprehensive Rheumatology

  https://comprehensiverheumatology.com/index.html@p=1348.html

  Adult-onset Stills disease (AOSD) is a rare inflammatory condition characterized by high fevers, joint pain, and a distinctive salmon-colored rash. While theres no cure, various treatment approaches can help manage symptoms and improve quality of life. […] Pharmacological management: First-line: Nonsteroidal anti-inflammatory drugs (NSAIDs): Commonly prescribed oral medications such as Ibuprofen, Diclofenac, Indomethacin, Celebrex, Meloxicam. Corticosteroids (Prednisone, Methylprednisolone, Dexamethasone): Medications that work by suppressing the immune response in AOSD. […] Second-line: Disease-modifying antirheumatic drugs (DMARDs) […] Third-line: Biologic agents like TNF-alpha inhibitors and IL-1 inhibitors may be considered in refractory cases. […] AOSD can be a chronic and relapsing-remitting disease with variable clinical courses. Early diagnosis and treatment are crucial to prevent joint damage and improve long-term outcomes.

• #2 Adult Still disease: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000450.htm

  Adult Still disease (ASD) is a rare illness that causes high fevers, rash, and joint pain. It may lead to long-term (chronic) arthritis. […] The goal of treatment for adult Still disease is to control the symptoms of arthritis. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are most often used first. […] Prednisone may be used for more severe cases. […] If the disease is severe or persists for a long time (becomes chronic), medicines that suppress the immune system might be needed. Such medicines include: Methotrexate, Anakinra (interleukin-1 receptor agonist), Tocilizumab (interleukin 6 inhibitor), Tumor necrosis factor (TNF) antagonists such as etanercept (Enbrel). […] Contact your provider if you have symptoms of adult Still disease. […] If you have already been diagnosed with the condition, you should call your provider if you have a cough or difficulty breathing.

• #2 Adult Still disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adult-stills-disease/diagnosis-treatment/drc-20351912

  If you’re taking high doses of prednisone, talk to your care provider about taking more calcium and vitamin D supplements to help prevent osteoporosis. […] Although you might not want to work out if your joints ache, exercise is recommended for all types of arthritis. Exercise can help you keep your range of motion and relieve pain and stiffness.

• #2 Management of Adult-Onset Still’s Disease Patients in Intensive Care Unit: a Case Report | Andriani | JAI (Jurnal Anestesiologi Indonesia)

  https://ejournal.undip.ac.id/index.php/janesti/article/view/65781

  Adult-onset Still’s disease (AOSD) is a rare inflammatory disorder characterized by the classic triad of fever, arthritis, and evanescent rash. […] Management of such conditions in the intensive care unit (ICU) is crucial. […] The first-line therapy given was methylprednisolone, doses were tapered gradually. As the patient didn’t respond to therapy, she was then given immunosuppressive therapies such as cyclosporine, hydroxychloroquine and underwent therapeutic plasma exchange (TPE). […] Making a correct diagnosis and starting an appropriate treatment as soon as feasible is crucial in this case as the patient suffers complications.

• #2 Management of adult-onset Still’s disease: evidence- and consensus-based recommendations by experts

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11147545/

  IL-1 blockade interferes less during the diagnostic trajectory and can be used for a therapeutic trial. […] Severe systemic disease: either monotherapy IL-1 blockade, or GC and IL-1 blockade, or monotherapy GC. […] Step-up to IL-1 blockade should be considered in insufficient response on GC monotherapy or upon GC dependence. […] Severe arthritis predominant: MTX and GC combination therapy, GC and IL-6 blockade combination therapy; IL-1 blockade and GC combination therapy; or IL-1 blockade monotherapy. […] TNF blockade may be used in arthritis-predominant AOSD patients without systemic symptoms and upon suboptimal response to both IL-1 and IL-6 blockade.

• #2 Adult Still disease | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/adult-still-disease

  Adult Still disease can damage joints, particularly the wrists. Treatment involves medicine to reduce pain and help control the disease. Prednisone is often used if pain relievers such as ibuprofen (Advil, Motrin IB, others) are not enough. […] A variety of medicines are used to treat adult Still disease. The type of medicine depends on how bad the symptoms are and possible side effects. […] Many people who have adult Still disease require treatment with steroids, such as prednisone. These powerful drugs reduce inflammation. They may lower the body’s resistance to infections and increase the risk of developing osteoporosis and diabetes. […] Even if you have no symptoms some days, it’s important to take your medicines as your care provider recommends. Controlling inflammation helps reduce the risk of complications.

• #2 Adult-onset Still’s disease | Symptoms, treatments and new research

  https://versusarthritis.org/about-arthritis/conditions/adult-onset-still-s-disease/

  Adult-onset Stills disease, sometimes known as AOSD, is a rare type of inflammatory arthritis. […] Adult-onset Stills disease is an autoimmune condition. This means that the condition is caused by your body’s immune system. […] AOSD can cause pain and stiffness in your joints, as well as inflammation in other areas of your body. […] People with AOSD frequently experience joint pain, going on to develop arthritis. Arthritis causes pain, swelling and stiffness in the joints. […] Many people with AOSD can live a full and normal life with the right treatment. […] Your rheumatology team will be able to advise you on treatments and things you can do for yourself to reduce the symptoms of AOSD. […] You should carry on taking the drugs given to you by your doctor, even in periods when you’re feeling better, as this will reduce the risk of flares.

• #2 Still’s disease: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/stills-disease

  Improving mental well-being: Stress can worsen the symptoms of AOSD. Good sleep hygiene, relaxation techniques, talking therapies, and counseling can all help people manage their mental health. […] A person should talk with a doctor to identify the best treatment and management plan for their symptoms.

• #2 Anyone out there with Adult Onset Still’s Disease? – Page 6 — Versus Arthritis

  https://community.versusarthritis.org/discussion/23425/anyone-out-there-with-adult-onset-stills-disease

  I understand that you have had a diagnosis of Adult-Onset Still’s Disease (AOSD) from the age of 27. You are finding life very difficult and are taking a lot of medication to treat the disease. […] Our web site has a great page of information on AOSD, which includes information on treatments, managing your symptoms and living with Adult-Onset Still’s Disease. […] One thing I can’t stress enough is don’t neglect your mental health. The disease you will fully recover from, in a few more years. The mental health problems, you never recover from. […] It sounds bizarre, but take your mental health even more seriously than you are taking the disease. The disease, you will recover from. Whether it’s 18 months or 5 years. It’s inevitable. […] I’m sorry to hear of everything you are experiencing with your recent diagnosis of Adult onset stills disease, AOSD, this must be really tough for you, but hopefully you will get more information at your Rheumatology appt next week. […] You can also find lots of useful information on our Versus Arthritis website including how you can manage pain and the treatments available for people with different kinds of arthritis.

• #2 Adult-Onset Still Disease – What You Need to Know

  https://www.drugs.com/cg/adult-onset-still-disease.html

  AOSD cannot be cured or prevented. Treatment focuses on slowing the progression of AOSD and preventing or managing flares. […] The following may be used to help control symptoms of AOSD: […] Rest as needed. You may feel more tired than usual. Try not to do too much during the day. […] Manage stress. Stress is the main trigger for AOSD flares. […] Apply ice. Ice helps relieve joint pain and reduces swelling. […] Apply heat. Heat helps relieve joint and muscle pain. […] Be physically active, as directed. Physical activity, such as exercise, may help your joints feel less stiff. […] Keep taking your medicine, even if you feel better. AOSD flares come and go. […] You have the right to help plan your care. Learn about your health condition and how it may be treated.

• #2 Adult Onset Still’s Disease: A Retrospective Study of Objective Manifestations and Outcomes – ACR Meeting Abstracts

  https://acrabstracts.org/abstract/adult-onset-stills-disease-a-retrospective-study-of-objective-manifestations-and-outcomes/

  Adult Onset Stills Disease (AOSD) is a complex and rare inflammatory disease with life threatening complications. […] We identified 185 patients with AOSD with an incidence rate of 0.16 to 0.21 per 100,000. […] Nearly 24% of patients required ICU level of care and overall mortality rate was 3.2%. […] Our study establishes patient demographics and common objective findings to better understand and diagnose this rare disease. […] Objective data also further solidified known lab abnormalities in this group including elevated inflammatory markers, leukocytosis, and anemia. […] Prior studies have suggested that concomitant pneumonia caused greater severity of disease with increased mortality. This differed in our population, although our study was limited by lack of follow-up data. Further studies may analyze patients who fit Yamaguchi criteria as well as complications and long term outcomes.

• #2

  https://journals.lww.com/ccejournal/fulltext/2021/05000/adult_onset_still_s_disease_presenting_as.33.aspx

  We report a case of a young woman with adult-onset Stills disease presenting as macrophage-activation syndrome complicated by shock and respiratory failure during the third trimester of pregnancy. […] To our knowledge, this is the first report of new-onset adult-onset Stills disease during the third trimester of pregnancy, which presented as macrophage-activation syndrome. […] Clinicians should consider this diagnosis when evaluating a pregnant patient with unexplained fever and multiorgan dysfunction. […] AOSD is a rare inflammatory disorder classically characterized by high fever, arthritis, and an evanescent salmon-colored rash. […] HLH is a systemic immune hyperactivation syndrome that can be a primary process in genetically predisposed individuals or can be triggered by another process, often a viral infection or malignancy. […] Although pulmonary involvement is not characteristic of either AOSD or MAS, it can occur in both disorders. […] In summary, we illustrate that AOSD can present as MAS during the third trimester, and can mimic or raise concern for peripartum disorders such as HELLP syndrome.

• #2 Still’s disease: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/stills-disease

  A person may still need to take these medications even after the symptoms go away. This maintenance therapy can keep inflammation under control and prevent further bone, cartilage, and organ damage. […] People can take steps to help manage the symptoms of AOSD. These steps include: […] Engaging in regular physical activity: Exercising and staying active can help maintain the range of motion of the joints and keep the muscles strong. It can also help a person maintain a moderate weight, reducing strain on the joints. […] Adhering to a healthy eating pattern: Alongside exercise, a nutritious, balanced diet can help control a persons weight, improve energy levels, and reduce fatigue. […] Reducing strain: Using joint protection techniques, pacing activities carefully, and including sufficient breaks in the day can help reduce the strain on joints.

• #2 Adult Still disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adult-stills-disease/symptoms-causes/syc-20351907

  Adult Still disease can damage joints, particularly the wrists. Treatment involves medicine to reduce pain and help control the disease. Prednisone is often used if pain relievers such as ibuprofen (Advil, Motrin IB, others) are not enough. […] If you have a high fever, rash and achy joints, see your health care provider. Also, if you have adult Still disease and develop a cough, difficulty breathing, chest pain or any other symptoms that are not usual, call your health care provider. […] Adult Still disease inflames the organs and joints. Most complications from the disease result from this inflammation. […] The chronic swelling and irritation that occurs with adult Still disease can damage the joints. The most commonly involved joints are the knees and wrists. Sometimes other joints, including the neck, foot, finger and hip joints, also are affected.

• #2 Adult onset Still disease

  https://dermnetnz.org/topics/adult-onset-still-disease

  Adult-onset Still disease is a rheumatic disorder, characterised by: […] The main goals of treatment are to reduce joint inflammation and avoid deformity. Therapy may include both medical and surgical interventions. In addition, the patient and their families need to fully understand the nature of the disease and how to live with it for the rest of their lives. […] Non-drug therapy includes physiotherapy, hydrotherapy and simply rest. Patients with Still disease will experience good and bad days. The number of bad days, that is flare-ups or exacerbations of the disease, can be controlled or reduced by careful planning of activities and rest periods. It has been shown that physical and emotional stress can exacerbate symptoms of Still disease.

• #2 Adult Still’s Disease

  https://www.arthritis.org/diseases/adult-stills-disease

  Adult-onset Stills disease is a rare type of arthritis that is thought to be autoimmune or autoinflammatory. […] Doctors use several drugs to treat adult Still’s disease. Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) help to reduce mild pain and inflammation. […] With adult Stills disease, the medications may need to be taken even after symptoms go away. This is called maintenance therapy. Its important to keep inflammation under control to prevent damage to joints and organs. […] Caring for the body and mind are key components of an adult Still’s disease management plan. Make positive and healthy lifestyle choices and acknowledge the physical and emotional effects of arthritis. Proper nutrition, activity, rest and following doctors’ orders are important for managing the condition and possible medication side-effects.

• #3 Adult Still disease | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/adult-still-disease

  If you’re taking high doses of prednisone, talk to your care provider about taking more calcium and vitamin D supplements to help prevent osteoporosis. […] Although you might not want to work out if your joints ache, exercise is recommended for all types of arthritis. Exercise can help you keep your range of motion and relieve pain and stiffness.

• #3 Comprehensive Treatment for Still’s Disease in Atlanta

  https://argmd.net/conditions-we-treat/adult-onset-stills-disease/

  Symptom Management: Using medications, therapies, and lifestyle changes to manage symptoms and reduce flare-ups. […] Regular Check-Ups: Keeping up with appointments to monitor disease progression and treatment efficacy. […] Support Systems: Seeking support from family, friends, or support groups to manage the emotional impact of living with a chronic disease. […] Education: Learning about the condition and staying informed about new treatments and management strategies. […] At Arthritis and Rheumatology of Georgia, we offer comprehensive care for AOSD, including diagnostic tests, personalized treatment plans, and ongoing management to reduce inflammation and improve quality of life.

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