View source for Adult-onset Still's disease

==Background==

*Inflammatory condition of unknown etiology characterized by fever, rash, and arthritis

==Clinical Manifestations==

*The classic triad includes fevers, joint pain, and a maculopapular salmon-colored rash
**Arthritis or arthralgia: usually knees, wrists, and ankles
**Rash: evanescent, salmon‐pink, maculopapular eruption, predominantly found on the proximal limbs and trunk
**Fever: over 39°C, transient, lasting typically under 4 hours
*Sore throat
*Myalgia
*Lymphadenopathy
*Splenomegaly
*Pleuritis
*Pericarditis

==Differential Diagnosis==

*[[Reactive arthritis]]
*Other [[spondyloarthropathies]]
*[[Haemophagocytic syndrome]]
*[[Dermatomyositis]]
*[[Kikuchi syndrome]]
*[[Sweet syndrome]]
*Granulomatous disorders
*[[Vasculitis]]
*[[Periodic fever syndrome|Periodic fever syndromes]]
**[[Familial Mediterranean fever]]
**[[TNF receptor associated periodic syndrome]] (TRAPS)

==Investigations==

*RF and ANA, which should be negative
*Elevated ferritin, typically over 1000
*CBC may show leukocytosis, anemia, thrombocytosis
*Elevated liver enzymes and LDH

==Management==

*[[NSAID|NSAIDs]], corticosteroids, and antirheumatic agents

[[Category:Rheumatology]]