Still disease, also known as systemic juvenile idiopathic arthritis (SJIA), is a type of childhood rheumatism that typically affects children under the age of 16. It is considered an autoimmune disease where the immune system mistakenly attacks the body’s own cells. This disease is characterized by inflammatory symptoms and can have effects on multiple body systems. Although the exact cause of Still disease is unknown, it is believed to be triggered by an autoimmune response. Diagnosis is made by a pediatric rheumatologist based on symptoms and physical examination. The diagnosis is confirmed by ruling out other possible causes such as other types of rheumatism and infections. Treatment can vary depending on the severity of symptoms and organ involvement. Medications such as nonsteroidal anti-inflammatory drugs, corticosteroids, and immunosuppressive drugs are commonly used.
Causes of Still Disease
The exact causes of Still disease are not fully understood, but genetic and environmental factors are believed to play a role:
Genetic Factors: Genetic predisposition can increase the risk of developing Still disease.
Environmental Factors: Certain environmental factors, particularly viral infections or other infections, are thought to play a triggering role in the onset of the disease.
Immune System Abnormalities: In Still disease, the immune system mistakenly attacks normal body cells.
Genetic Mutations: Some genetic mutations are believed to contribute to the development of Still disease.
Symptoms of Still Disease
Symptoms of Still disease can vary from person to person and may differ based on the severity of the disease:
- fever
- joint problems
- rash
- enlargement of lymph nodes
- abdominal pain
- fatigue
- loss of appetite
- weakness and rapid fatigue
- organ involvement
Diagnosis of Still Disease
Diagnosis of Still disease is typically made by a pediatric rheumatologist, taking into consideration symptoms, physical examination, and laboratory tests:
Symptoms and Physical Examination: The doctor carefully evaluates the patient’s symptoms and medical history.
Laboratory Tests: Blood tests can help in the diagnosis of Still disease.
Synovial Fluid Analysis: Synovial fluid analysis can be done to evaluate inflammation in the joints.
Imaging Tests: In some cases, imaging tests such as X-rays, ultrasound, or magnetic resonance imaging (MRI) may be performed to evaluate joint and internal organ problems.
Diagnostic Criteria: Still disease is diagnosed based on diagnostic criteria.
Treatment of Still Disease
Treatment of Still disease can vary depending on the severity of symptoms and the areas of the body affected:
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs may be prescribed to relieve pain and reduce inflammation.
Corticosteroids: Corticosteroid medications can rapidly reduce inflammation.
Immunosuppressive Drugs: Immunosuppressive drugs like methotrexate can be used to control excessive immune response and alleviate symptoms.
Biological Drugs: Biological drugs may be used to regulate the immune response.
Physical Therapy and Rehabilitation: Physical therapy and rehabilitation programs are important for increasing joint mobility, maintaining muscle strength, and improving physical function.
Pain Management: Pain control is important for improving the patient’s quality of life.
Diet and Exercise: A healthy lifestyle can support the patient’s overall health.
Psychosocial Support: Psychosocial support is important for children with Still disease and their families.
Regular Follow-up and Monitoring: Regular doctor visits and laboratory tests are necessary throughout the treatment process.
Management of Still Disease
The management of Still disease aims to control symptoms, reduce inflammation, and improve the patient’s quality of life:
Regular Doctor Visits: The patient should be regularly monitored by a pediatric rheumatologist or a specialist doctor.
Medication Therapy: The patient should regularly take the medications prescribed by the doctor.
Physical Therapy and Rehabilitation: Physical therapy and rehabilitation programs are important for improving joint mobility, maintaining muscle strength, and enhancing physical function.
Pain Management: Pain control is important for improving the patient’s quality of life.
Psychosocial Support: Psychosocial support is important for children with Still disease and their families.
Healthy Lifestyle: Healthy eating, adequate rest, and regular exercise can support the patient’s overall health.
Immunization: The patient should receive vaccinations according to the current immunization schedule to protect against infections.
Family Education: The patient and their family should understand the symptoms of the disease, treatment options, and the importance of the treatment plan.
Laboratory and Imaging Monitoring: The doctor may recommend regular laboratory tests and imaging studies for the patient.