Stylo disease in adults and children

Still's disease in adults and children: causes, symptoms, treatment

The most important role in the treatment of a rare disease is played by diagnostics, which makes it possible to differentiate the disease with a number of other disorders with health. Treatment of the disease is long, but the prognosis in patients who turned to a specialist on time, in most cases good.

History of the disease

For the first time about the disease learned in 1897 thanks to the doctor George Still. But at this time, Still's disease was considered only one form of rheumatoid arthritis. It was not until 1971 that Eric Bywaters published research highlighting the disease from a series of problems with similar symptoms.

Medical statistics show that both men and women can equally get a rare disease.

Given the young age of most patients, the diagnosis becomes more complicated, since it is difficult for parents who first noticed symptoms in a child to believe in having such an "age" problem.

Causes of the disease

So far, the etiology of the development of the disease is unclear.

Numerous studies aimed at identifying the factor that provoked Still's disease in adults and children have not yielded results.

According to the generally accepted hypothesis, the disease is the result of exposure to the body of infectious or viral agents, but there is no evidence supporting this statement.

Doctors tried to associate the disease with pregnancy, the use of medications, including female hormones, stress and other factors. According to some data, Still's disease belongs to autoimmune disorders.

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Only the fact that in the active phase the disease is characterized by changes in the concentration of cytokines has been reliably proven.

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Perhaps in the future, medicine will be able to identify the cause of the disease, thereby simplifying its diagnosis and speeding up the recovery of patients.

Symptoms of Still's disease in adults

Still's disease, the symptoms of which are similar to a number of other diseases, are diagnosed by several indicators:

• The fever that occurs with Still's disease differs from the fever inherent in a number of infectious diseases by its inconsistency. Traditionally, the temperature during the day is kept within normal limits, but twice a day it rises to 39 degrees and above. At the same time, in a fifth of patients, there is no reduction in temperature and improvement in the patient's well-being, which significantly complicates the diagnosis.
• At the peak of temperature rise, the patient exhibits skin rashes, represented by pink papules or maculae. Most often the rash is located on the trunk and in the proximal parts of the limbs, less often - the rash is represented on the face. In a third of patients, the rash rises above the skin, appearing mainly in places of friction and squeezing. A similar symptom is called the Kebner phenomenon. Not always the rash is accompanied by itching, and its rather pale pink color and periodic disappearance make the symptom inconspicuous for the patient. Doctors for the diagnosis are forced to subject the patient to heat, which activates the appearance of rashes. It can be a warm shower or the application of warm napkins. Atypical manifestations of the disease are: alopecia, erythema nodosum, petechial hemorrhages. But in practice, such symptoms are extremely rare.

• The initial stage of Still's disease is characterized by the appearance of myalgias and arthralgias. At first, only one joint is affected. Over time, the disease covers other joints, assuming the nature of polyarthritis. First of all, knee, ankle, wrist, hip, temporomandibular, metatarsophalangeal joints are affected. But the peculiarity of the disease, the most typical for most cases, is the development of arthritis of distal interphalangeal joints of the hands. This is what makes it possible to differentiate Still's disease from rheumatic fever, red systemic lupus erythematosus or rheumatoid arthritis.
• 65% of patients with a disease develop lymphadenopathy. Half of the patients have cervical lymph nodes. In some cases, lymphadenitis takes a necrotic character.
• At the beginning of the disease, patients notice a marked burning in the throat, which is permanent.
• For Still's disease, cardiopulmonary manifestations are also characteristic, such as aseptic pneumonitis, cardiac tamponade, valve vegetations, respiratory distress syndromes.
• In patients, ophthalmic disorders are noted. This is a complicated cataract, ribbon-like degeneration of the cornea, iridocyclitis.

Still's disease in children

The symptomatology of the disease in children does not differ from the adult. However, the manifestations of Still's disease in childhood can be blurred, leading to late diagnosis and untimely treatment. Sometimes polyarthritis in childhood leads to disability.

To avoid this, parents should be extremely attentive to the physical condition of the child. And at the first symptoms of the disease, contact a qualified specialist.

The initiated disease of Still in children can provoke disproportionate growth of the extremities, which will require surgical intervention.

Diagnosis of the disease

Since the specific symptoms of the disease are practically absent, the diagnosis is more difficult. In every twentieth case, Still's disease is treated as an unexplained fever. In a number of cases, a diagnosis of sepsis is made.

And only after a series of unsuccessful courses of antibacterial therapy and a number of additional tests, doctors come to the conclusion that this is the Still's disease of adults. Treatment and rehabilitation - procedures are long and require constant medical supervision.

The same applies to children.

When the diagnosis is made, symptoms like heat, swelling of the joints, enlarged lymph nodes and inflammation of the throat, and other indicators obtained with the help of echocardiograms, computed tomography and Ultrasound.

Required and a blood test, showing the level of platelets and leukocytes. With Still's disease, the patient is characterized by a decrease in the level of red blood cells. In adults, C-reactive protein and ferritin are elevated.

In this case, the tests for antinuclear antibodies and rheumatoid factor are usually negative.

Treatment during remission

Complex and stage-by-stage treatment is carried out both in the active phase of the disease and during the remission period.

In the first case, procedures are performed in a hospital setting, in the second case, patients receive the necessary therapy while on ambulatory treatment or in sanatoriums and resorts.

Therapy includes medication, physiotherapy, physiotherapy and massage.

Treatment during an exacerbation of the disease

During the exacerbation of the disease, patients take NSAIDs, immunosuppressants, glucocorticoids. Treatment is always lengthy.

That's why both the patient himself and his relatives need to stock up with a large dose of patience.

Still's disease in adults and children is a serious disease, and it can be managed only with timely diagnosis and correctly prescribed treatment.

Forecast

After treatment, there are three possible forms of the disease. The best of them is spontaneous recovery, observed in a third of patients with a rare diagnosis. A third of patients have a recurring form of the disease.

The most difficult variant is chronic Still's disease in adults.

Treatment, recovery and rehabilitation in this case can include not only traditional therapy, but also arthroplasty, which allows to restore the joints destroyed by the disease.

A source: http://.ru/article/190530/bolezn-stilla-u-vzroslyih-i-detey-prichinyi-simptomyi-lechenie

Still's disease

Still's disease- a serious disease, manifested by fever, polyarthritis. Transient rashes on the skin and systemic inflammatory lesions of somatic organs.

Stylle's disease is diagnosed using a method of excluding other diseases on the basis of clinical symptoms, laboratory data, results of studies of affected joints, lymphoreticular and cardiopulmonary system.

The treatment of the Still's disease is carried out mainly with non-steroidal anti-inflammatory and glucocorticoid drugs, cytostatics are the reserve drugs.

Still's disease was described as early as 1897 by the British doctor George Still. For a long time, it was considered a severe form of juvenile form of rheumatoid arthritis.

According to statistics, which leads modern rheumatology, the prevalence of the disease Still in recent years is about 1 person per 100 thousand. of the population.

Women and men are equally susceptible to morbidity. The greatest number of cases of Still's disease occurs in children under the age of 16 years.

Because of the absence of specific symptoms of the disease, patients with Still's disease often, despite the negative results bacteriological cultures of blood, diagnose "sepsis because of which they undergo repeated courses antibiotic therapy. It is noted that about 5% of cases of Still's disease are initially treated by doctors as "fever of unknown origin".

The causes of the disease Stilla

Numerous studies in the field of etiology of Still's disease did not give an answer to the question of its causes. Sudden onset, high fever, lymphadenopathy and blood leukocytosis indicate the infectious nature of the disease.

However, a single causative agent has not yet been identified. In some cases of Still's disease, rubella virus was detected in patients, in others - cytomegalovirus.

There were cases of disease associated with parainfluenza virus, Epstein-Barr virus, mycoplasma, and escherichia.

You can not exclude the presence of a hereditary predisposition to the development of the disease Still. But the final results confirming the relationship of the disease with the loci HLA, have not yet been received.

The immunological theory that relates Still's disease to autoimmune diseases is confirmed only in In some cases, when CEC is detected in patients that cause the development of an allergic vasculitis.

FeverWith Still's disease, the temperature rises to high figures (39 ° C and above). Unlike most infectious diseases, it is not permanent. The most typical one-time rise in temperature during the day, usually in the evening.

Less frequent are 2 temperature peaks per day. In most patients, the temperature between the peaks decreases to normal numbers, which is accompanied by a significant improvement in the general condition. Approximately 20% of patients with Still's disease do not normalize body temperature.

Rasheswith the illness of the Still, as a rule, arise at the height of the rise in body temperature and are of an incoming character: they disappear, they reappear.

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Elements of the rash are mostly flat pink spots (maculae) or papules located in the proximal parts of the limbs and on the trunk, less often on the face.

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In 30% of the cases, Steele disease rises above the general surface of the skin and occurs in places of trauma or compression of the skin (the phenomenon of Kebner). Sometimes they are accompanied by itching.

The pink color of the rash, its periodic disappearance and the absence of subjective sensations often make the rash invisible to the patients.

In some cases, the doctor has to examine the patient immediately after a warm shower or resort to thermal effects on the skin, for example, by applying warm wipes to detect a rash. There are atypical skin manifestations of Still's disease: petechial hemorrhages, erythema nodosum, alopecia.

Articular syndrome. Arthralgia, along with myalgias, at the onset of Still's disease is attributed to general manifestations of the disease, caused by a high temperature rise. At the initial stage, arthritis can affect only one joint.

The most typical of the Still's disease is the development of arthritis of the interphalangeal distal joints of the hand.

This feature allows you to differentiate the disease from rheumatoid arthritis, rheumatoid arthritis fever, systemic lupus erythematosus, which is not characterized by the damage of these joints in young age.

Lesion of lymphoreticular organsincludes hepatosplenomegaly and lymphadenopathy. Lymphadenitis is observed in 65% of patients with Still's disease. In half of cases of the disease, there is an increase in cervical lymph nodes.

The enlarged lymph nodes in Still's disease retain their mobility, they have a moderately dense consistence. The expressed compaction of the lymph node, its isolated enlargement or adhesion to surrounding tissues should be alarmed oncologically.

In atypical cases, lymphadenitis can take a necrotic character.

A sore throatdisturbs 70% of patients with the disease of the Still and manifests itself usually at the onset of the disease. It is characterized by a pronounced burning in the throat and is permanent.

Cardiopulmonary manifestationsStylle's disease is most often characterized by serosity: pleurisy and / or pericarditis.

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In 20% of cases, aseptic pneumonitis occurs, often with symptoms of bilateral pneumonia (cough, shortness of breath, high fever), which do not go against the background of intensive antibiotic therapy.

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To the more rare lesions that occur in Still's disease are: myocarditis, cardiac tamponade, the appearance of valvular vegetations with a clinical picture of infective endocarditis, respiratory distress syndrome.

The absence of specific diagnostic signs of Still's disease makes her diagnosis difficult for Rheumatologist, requiring a certain period of observation of the patient and often based on the exclusion of others diseases.

In the clinical analysis of blood marked leukocytosis and accelerated ESR. The overwhelming majority of patients with Still's disease have an ESR higher than 50 mm / h.

In this case, despite the typical for the disease Stille clinical signs of severe systemic inflammation, in the blood no rheumatoid and antinuclear factors are detected, and bacterial bacillus for sterility gives a negative result. Biochemical tests of the liver show an increase in the activity of its enzymes.

X-ray examination of the joints reveals effusion in the joint cavity, swelling of the soft tissues, less often - osteoporosis of the joints forming the joint.

In patients with chronic form of the disease, typical is the presence of ankylosis in the wrist joints.

When performing joint puncture, an aseptic synovial fluid with inflammatory changes is obtained.

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If necessary, patients with Still's disease undergo a biopsy of the lymph node, which allows to exclude its malignant metastatic lesion.

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Cardio-pulmonary manifestations of the Still's disease require consultation of a cardiologist and pulmonologist, lung radiography, ultrasound of the pleural cavity, ECG, ultrasound of the heart, etc.

Differential diagnosis of Still's disease is carried out with rheumatoid arthritis, psoriatic arthritis, dermatomyositis, lymphoma, tuberculosis, sarcoidosis, granulomatous hepatitis, infective endocarditis, systemic vasculitis and other

Treatment of Still's disease

In an acute period for 25% of patients, it is sufficient to prescribe drugs from the group of non-steroidal anti-inflammatory drugs. Their reception, depending on the clinic of the disease, takes from 1 to 3 months.

Changes in the heart and lungs are an indication for glucocorticosteroid therapy with drugs of prednisolone or dexamethasone. However, these drugs do not always have a sufficient effect.

In some cases, resistant to the traditional treatment of cases of Still's disease, it is possible to use infliximab and etanercept.

Forecast of Still's disease

The outcome of Still's disease can be spontaneous recovery, transition to a recurrent or chronic form. Recovery occurs in 1/3 of the patients, usually within 6-9 months from the onset of the disease.

The recurring course of the Still's disease in 2/3 of the patients is characterized by the appearance of only one attack (exacerbation) of the disease, which can happen in the period from 10 months to 10 years.

A small proportion of patients experience a cyclic recurrence of the disease with repeated attacks.

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The most severe is the chronic form of the disease of the Still, flowing with a pronounced polyarthritis, leading to a restriction of movements in the joints. Moreover, the earlier appearance of arthritis symptoms is an unfavorable prognostic sign.

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Among adult patients with Still's disease, the five-year survival rate is comparable to that of SLE and is 90-95%.

Patients may die from secondary infection, amyloidosis, hepatic insufficiency, coagulation disorders, heart failure, pulmonary tuberculosis, respiratory distress syndrome.

A source: http://www.krasotaimedicina.ru/diseases/rheumatology/still-disease

Still's disease in adults and children: signs, symptoms and treatment

Still's disease is called so because for the first time in 1897 it was described by the doctor George Still.

But in those days, pathology was considered just a form of rheumatoid arthritis.

Scientist Erik Byuoters published works in 1971, thanks to which the disease was isolated from a number of others with similar symptoms.

Statistics show that neither women nor men are immune from the disease, but most often the disease is observed in children under 16 years of age. Still's disease in adults is much less common.

In connection with this, the diagnosis is complicated, as parents do not immediately notice the symptoms of the disease, and children do not understand the changes taking place in their body.

Causes leading to the development of pathology

Physicians still have not figured out the true nature of the disease. Numerous studies, the purpose of which was to determine the factor that caused the disease in children and adults, did not bring the desired results.

Today it is considered that the disease occurs as a result of exposure to the patient's body of viral or infectious agents. But there is no confirmation of this hypothesis.

The doctors tried to link the pathology with:

• intrauterine development;
• use of medicines during pregnancy;
• stress and other factors.

Disease according to some data refers to autoimmune disorders. But only the fact that the active phase for pathology is characterized by changes in the quantitative content of cytokines is reliable.

How the disease manifests itself in adults

Symptoms of the disease are very similar to the symptoms of other joint diseases, but diagnose it by several indicators.

The fever characteristic of Still's disease differs from that observed in a number of infectious diseases and is expressed in its inconstancy. Usually during the day the temperature is within normal limits, but twice a day it jumps up to 39 and even higher.

And in 20% of patients, improvement of health and decrease in temperature indices is not observed. This fact significantly complicates the diagnosis.

In a third of patients, the rash rises above the skin, and it appears mainly in the areas of compression and friction.

This symptom is called "Kebner phenomenon."

The rash is not always accompanied by itching, and its periodic disappearance and pale pink color make the symptom invisible even for the patient.

To make an accurate diagnosis, the doctor assigns a thermal impact to the patient, which activates the rashes and clarifies the picture. This can be the imposition of warm compresses or a warm shower. Typical for the disease are the following:

1. erythema nodosum;
2. alopecia;
3. petechial hemorrhages.

Although in practice, these signs of the disease are very rare.

Stylle's disease in the initial stage is characterized by the appearance of arthralgias and myalgias. And first only one joint is affected, over time the disease resembles polyarthritis and spreads to other joints.

First of all, suffer ankle, knee, hip, wrist, metatarsophalangeal temporomandibular joints. But a characteristic feature of the pathology typical for most cases is the development of distal interphalangeal hand diarrtosis.

It is on this basis that it is most often possible to diagnose this ailment and distinguish it from red systemic lupus, rheumatic fever, rheumatoid arthritis.

In 65% of patients with Still's disease, the disease leads to lymphadenopathy, and in 50% of the patients lymph nodes on the neck increase. Sometimes lymphadenitis passes into the necrotic stage

For pathology, cardiopulmonary manifestations are typical, in particular:

• respiratory distress syndromes;
• valvular vegetation;
• cardiac tamponade;
• aseptic pneumonitis.

Ophthalmic disorders:

1. iridocyclitis;
2. ribbon-shaped degeneration of the cornea of ​​the eye;
3. complicated cataract.

The course of Still's disease in children

In children, the symptomatology of the disease is the same as in adult patients. However, in childhood, symptoms of Still's disease can be lubricated, which greatly complicates the diagnosis and leads to late-onset treatment. Polyarthritis in childhood often ends in disability.

That's why parents should be especially attentive to the well-being and physical state of their child. Launched at a young age, Still's disease can cause disproportionate development of the limbs, which requires surgical intervention.

Since the specific signs of pathology are practically absent, the diagnosis of Still's disease in children is considerably hampered. Every twentieth case of this disease doctors diagnosed as a fever of unknown etiology, often the verdict of doctors becomes "sepsis".

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And only when a series of courses of antibiotic therapy does not bring positive results and after conducting additional laboratory studies, doctors agree that this is a disease Stilla.

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The disease requires long-term treatment, no less than a long-term rehabilitation of constant medical supervision.

When making a diagnosis, the following factors are taken into account:

1. temperature increase;
2. increased lymph nodes;
3. swelling of the joints;
4. sore throat;
5. results of echocardiogram, ultrasound and computed tomography;
6. A blood test showing the concentration of platelets and leukocytes.

With Still's disease in the patient's blood, the level of red blood cells decreases. An increase in ferritin and C-reactive protein is characteristic for adult patients.

Therapy during remission and exacerbation, prognosis

Phased and complex treatment is prescribed both in the acute phase and during the remission of the disease. In the first case, the therapy is carried out under in-patient conditions, and in the second case, patients are on out-patient treatment and receive procedures at home or in the sanatorium-resort establishments.

Therapeutic course consists of:

• taking medicines;
• physiotherapeutic procedures;
• massage;
• exercise therapy (joint gymnastics).

When there is a period of exacerbation of the disease, patients are prescribed NSAIDs, glucocorticoids, immunosuppressants. The treatment is always very long, so the patient and his family should be well-equipped with patience to overcome the disease.

And in adults and small patients, the disease is difficult, so diagnosing it and starting an adequate treatment on time is extremely important for a positive outcome.

The prognosis after the end of the therapeutic course has three directions:

1. Spontaneous recovery is the best that can be expected (observed in 30% of patients).
2. Periodically recurrent form of the disease - this prediction is waiting for another 30% of patients with this diagnosis.
3. The chronic form of the disease is the most difficult. In this case, not only conservative methods are used for treatment, but also arthroplasty, by means of which it is possible to restore the joints destroyed by the disease.

A source: http://sustav.info/bolezni/drugie/bolezn-stilla.html

How to recognize Still's disease in adults and children

Recommendations of orthopedist and rheumatologist ...

Initially, Still's disease was detected in children, but now it occurs in adult patients. There is an ailment of multiple arthritis (when several joints are inflamed) in combination with the general intoxication of the body and the appearance of skin rash.

The exact cause of the disease was not determined either in children or in adults. Many researchers consider the ailment infectious, however different viruses are different in different patients:

• cytomegalovirus;
• rubella;
• Epstein-Barra;
• parainfluenza.

In some cases, with Still's disease, both escherichia and mycoplasma are isolated.

Possible causative agent - cytomegalovirus

Some scientists associate the appearance of Still's disease with a weighed heredity, while others attribute it to autoimmune diseases.

What are the symptoms to recognize the disease?

information for reading

The disease of the Still appears in adults and in children with such symptoms:

1. Fever and a fever of 39 degrees with sharp changes: it can quickly rise and fall sharply.
2. Skin rash. It appears when the temperature rises, itching is accompanied in rare cases. Pink spots and tubercles (papules) are formed on the skin of the trunk, arms, legs, rarely on the face. The rash can pass and reappear.
3. Loss of appetite, nausea and vomiting.
4. Arthritis. Inflammation of one joint begins, with time, many joints are involved in the process: polyarthritis develops.
5. Enlargement of lymph nodes, often cervical.
6. Persistent choking and burning in the throat.
7. Shortness of breath, cough.
8. Enlargement of the liver and spleen.

Without timely treatment, Still's disease can be complicated by pleurisy, aseptic pneumonitis, myocarditis, pericarditis, and kidney failure.

The main symptom is pain in all joints

A characteristic feature of the disease is the inflammation of the interphalangeal distal joints of the hand, which is present practically in all patients. This symptom helps distinguish disease from rheumatoid arthritis.

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The exact diagnosis is determined by the presence of such symptoms:

• sharp changes in body temperature;
• the presence of arthritis;
• skin rash;
• enlargement of the liver;
• enlarged lymph nodes.

Arthritis in the patient should be observed for a period of months with a pronounced pain syndrome.

The disease can affect any joints

Must carry out radiography of joints. In this case, osteoporosis is detected, a slight narrowing of the joint gap and the wrist. There are no noticeable erosive changes in bones. In adults, in the chronic form of the Still's disease, ankyloses are detected in the wrist joints.

In addition, patients are prescribed lung radiography, ECG and ultrasound of the heart.

To exclude oncology, a biopsy of lymph nodes is performed.

Features of laboratory diagnostics

Specific signs of adult Stella disease, which can be identified in laboratory diagnosis, are as follows:

1. In the clinical analysis of blood, an increase in the rate of erythrocyte sedimentation (50 mm / h or more) is revealed.
2. Low hemoglobin, anemia.
3. Leukocytosis or leukopenia.
4. Increase in the level of seromucoid, transaminases and alkaline phosphatase in blood biochemistry.
5. Absence in the blood of rheumatoid and antinuclear factors with expressed arthritis.

Children in the biochemical analysis of blood additionally noted an increase in the serum ferritin level.

It is the clinical and biochemical blood tests that are an important stage in diagnosing the disease.

A blood test is performed for all patients with suspected Still's disease

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Treatment, as well as the speed of recovery for Still's disease, in adults and in children depends on the severity of the course of the disease.

In acute form appoint non-steroidal anti-inflammatory drugs that help get rid of the main symptoms of the disease.

When complications develop, glucocorticosteroids (dexamethasone or prednisolone), often in combination with methotrexate, are used.

In some cases, immunosuppressants are used: Infliximab and etanercept.

When severe form of the disease, Stella is prescribed cytostatics, for example, Cyclophosphamide, Ciclosporin A.

Forecast

Only a third of patients recover from the disease. The result from the treatment can be obtained 6-9 months after its beginning.

Outcome of the disease, other than recovery, can be:

• transition to a chronic form;
• development of recurrent form.

With a recurrent course of exacerbation can occur only once a period of 10 months to 10 years, it all depends on the individual characteristics of the body.

The chance of recovery is only for patients who have applied for treatment in time

The chronic form is a prognostically unfavorable outcome in the treatment of Still's disease. Patients develop polyarthritis, which leads to impaired mobility of the affected joints.

Complications of the disease can be:

• development of infections;
• kidney failure;
• disorders of cardiac activity;
• decreased blood clotting;
• pulmonary tuberculosis.

A person can die from the above pathologies.

Still's disease is difficult to diagnose, which makes it difficult to treat it. The mortality rate among patients is quite high (5%), therefore, when the first symptoms appear, you should immediately consult a doctor.

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A source: http://SustavInfo.com/bolezni/artrit/simptomy-i-lechenie-bolezni-stilla/

Still's disease: causes, symptoms, diagnosis and treatment features:

Still's disease was described in detail in 1897 by the English doctor George Still, after which he received his name. For a long time, pathology was referred to as juvenile arthritis.

And only in 1971, Eric Bywaters, observations were made of the disease in adult patients, according to which the pathology was isolated into a separate nosological group. According to statistical data, the frequency of the disease is: 00 000 people.

A larger number of patients are under the age of 16 years.

Causes of the disease

Numerous studies of this pathology have not shed any light on the nature of its occurrence. The disease is characterized by a sudden debut.

The beginning is characterized by a febrile state, the presence of lymphadenopathy and an increase in the white blood cell count, which indicates the infectious nature of the pathology.

However, the specific pathogen is not indicated.

In some cases, the patients are affected by rubella, cytomegalovirus, parainfluenza, mycoplasma, escherichia, the Epstein-Barr virus. The genetic basis of pathology is also not excluded.

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There is an immunological theory that relates Still's disease to the category of autoimmune diseases.

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Autoimmune disease involves the perception of own cells as foreign. The body begins to actively develop antibodies.

With Still's disease, antibodies attack joints. For this reason, there is a chronic inflammatory process that provokes destruction of the cartilage and a violation of the structure of the bones.

As a result, the joint loses its functionality.

Symptomatic disease in children and adults

How is Still's disease manifested? In children, the symptoms are similar to those in adult patients. The disease begins acutely.

Usually, the body temperature rises to 39 ° C. Usually it rises in the evening and provokes a strong chill.

By morning the temperature drops, which is explained by the high level of sweating.

How else is Still's disease manifested? Symptoms include rashes that are localized in the areas of compression of the skin.

This phenomenon occurs in one third of cases. Often, the rash is not noticeable to patients.

To detect it, the doctor examines the patient after taking a warm shower or applying thermal napkins to the skin.

A little later, the temporomandibular, knee, ankle, radiocarpal, hip, interphalangeal and ulnar regions are involved in the process.

The most striking feature is the inflammation of the area between the phalanges, which allows to determine the presence of the disease without application of differentiated diagnosis and distinguish pathology from systemic lupus erythematosus and rheumatoid arthritis.

Approximately half of the patients are provoked by lymphadenitis. As a rule, the enlargement of the lymph glands is noted in the neck region. They become mobile and dense to the touch.

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Many patients complain of pain in the throat, which worries at the very beginning of the disease. The choroid of the eyes can also be inflamed.

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Still's disease in children causes a feeling of nausea. There are desires for vomiting, a decrease in appetite and body weight. Sharply expressed pain syndrome. Pain in the throat region is noted in 70% of cases. It is expressed in a burning sensation.

As the pathology develops, the body becomes depleted, atrophic processes in the muscles, and degenerative changes in the joints.

There is also pronounced vegetative vascular dystonia, which manifests itself in rapid heart rate, hypotension, sweating and other manifestations. Many organs and systems are involved in the pathological process.

There is a change in the rheological parameters of the blood. There is leukocytosis, hypochromic anemia, leukopenia, accelerated ROE.

Diagnosis of the disease

How does Still's disease come to light? Diagnosis is accompanied by certain difficulties and involves the use of several manipulations.

The presence of the disease can be established through the following procedures:

• blood donation for analysis;
• bacterial culture of blood;
• biopsy of lymph nodes;
• radiography;
• by ultrasound;
• electrocardiogram.

Usually in the blood test there is an increase in the level of leukocytes and an accelerated process of ESR (above 50 mm / h.

) There is also an increased protein index, which is characteristic of the acute inflammatory stage of the disease.

Bacteriological seeding of blood does not result in sterility. Biochemical tests of the liver indicate an increase in the activity of its enzymes.

The study by means of X-rays indicates the presence of effusion in the joint cavity, edema of soft tissues. Significantly less marked development of osteoporosis.

In patients who have the disease of the Still in a chronic form, there is ankylosis in the joints in the area of ​​the wrist. When puncturing the joints, an aseptic synovial fluid with inflammation is obtained.

Differential diagnostics

Only the traumatologist can diagnose the child and the adult.

It is necessary to carry out a differentiated diagnosis to exclude such similar pathologies as rheumatoid arthritis, lymphoma, granulosa hepatitis, systemic vasculitis, psoriatic arthritis, tuberculosis, dermatomyositis, sarcoidosis, endocarditis of infectious genesis.

If necessary, patients are shown a puncture of the lymph node, which can exclude cancerous lesions.

Complications from the lungs and heart require consultation of a cardiologist and pulmonologist. Shows chest radiography, ultrasound of the pleura and heart.

Disease therapy

How is it performed in the presence of such a pathology as the Still's disease, in adults treatment? Recovery in the acute stage for 25% of cases occurs when prescribing drugs from the group of non-steroids. They have an anti-inflammatory effect and relieve pain.

The duration of reception of funds, regardless of the stage of the disease, is from 1 to 3 months. When choosing medicines for a child, the trauma doctor follows the safety of the drugs and selects doses on an individual basis.

Changes in the heart, lungs suggest the use of glucocorticosteroid therapy. Used drugs such as Prednisolone and Dexamethasone.

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How does the chronic form of the pathology, like the Still's disease, stop in adults? Treatment involves the use of the drug "Methotrexate".

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The reserve drug for patients with severe pathology is "Cyclophosphamide". Cytostatic promotes the inhibition of cell growth.

In some cases, "Infliximab" and "Etanercept" are used.

It is impossible not to recall rehabilitation measures. They contribute to improving the quality of life of a patient affected by inflammation of the joints.

Local treatment in the presence of such a disease as Styl's disease, involves the use of physiotherapy procedures: electrophoresis and magnetotherapy. When the inflammatory process is attenuated, the massage and therapeutic gymnastics are excellent.

The use of folk remedies

The replacement of traditional treatment with folk remedies is not expedient, since such treatment will not bring the desired result.

With the permission of the attending physician, it is possible to use coniferous baths that can reduce the pain syndrome. Needles are infused for 10 hours. You can also use compresses with cherry bones.

The stone is broken and a seed is extracted from it. A large number of seeds are crushed. On their basis, and a compress is prepared.

The main complications

Still's disease in a child can cause serious complications. As a rule, the target organ in this case is the heart, lungs. It is not excluded the development of pneumonia, pericarditis, pleurisy, endocarditis and myocarditis.

The main complications in the presence of ailment include:

• contractures;
• ankylosis;
• renal failure in chronic form;
• fall in visual acuity, provoked by uveitis;
• osteoporosis and fractures caused by it;
• disability.

Ophthalmic problems

And what about the pathology like Still's disease, ophthalmology? With pathology, often there is chronic fibrinous-plastic uveitis, complicated cataracts and ribbon-like dystrophic changes in the cornea. In severe cases, atrophy of the eyeball can be provoked.

Eye damage, as a rule, occurs after a considerable time after the onset of the disease. In some cases, uveitis, corneal dystrophy and cataract can act as the sole manifestation of Still's disease.

Prognosis of the disease

Often the pathology assumes a chronic or recurrent nature.

Half of patients in adulthood fully recover after about six months after the start of therapy.

The chronic form takes a heavy course and often flows in parallel with the polyarthritis. Disease, in turn, provokes restriction of joint mobility.

Complete recovery is noted in a third of patients. Relapses in 2/3 patients are characterized by the occurrence of a single attack, which can occur within 10 years. In a small number of patients there is a cyclical exacerbation with repeated attacks.

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The most severe form of the disease is chronic, which occurs with a pronounced polyarthritis, limiting the mobility of the joints. It should be noted that the early appearance of such a symptom is characteristic of an unfavorable course of the disease.

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The lethal outcome is 5%. It may occur with secondary infection, amyloidosis, liver or heart failure, blood clotting, tuberculosis, respiratory distress syndrome.

Prevention of disease

All preventive measures are aimed at preventing the development of the disease Still. Optimal to conduct them in the adolescent period in order to exclude the possibility of developing pathology.

Prophylaxis is the general strengthening of the immune system, a gradual hardening. It is obligatory to vaccinate against various infectious diseases.

Secondary prevention

Preventive measures of a secondary nature are not aimed at arresting the development of the secondary process.

The intake of medications recommended by the attending physician should be exercised in the spring and autumn.

This includes the use of calcium, sanitation of the mouth in people who are prone to frequent infectious diseases.

A source: https://www.syl.ru/article/299139/bolezn-stilla-prichinyi-simptomyi-diagnostika-i-osobennosti-lecheniya