Of still's disease

Of still's disease is one of the most severe forms of non-infectious (rheumatoid) polyarthritis. The disease is more common in the age of 3-5 years; are mostly girls.
Etiology and pathogenesis - see Arthritis (non-infectious).
The clinical picture. Beginning of the disease is acute, is manifested by the increase of temperature up to 38-40°, pain and swelling of the joints, the symptoms of intoxication. The defeat of multiple joints, because of the pain of their limited mobility, sooner develop contractures. In the field of interphalangeal joints may experience redness of the skin with their subsequent pigmentation. Many patients one of the primary symptoms of an allergic polymorphic rash, sooner endangered, but relapsed during exacerbations. Early occurs hyperplasia lymph nodes, there is often enlarged liver and spleen. As the illness progresses, increasing exhaustion, muscle atrophy, proliferative changes in the joints; there is a marked dystonia autonomic nervous system, manifested tachycardia, arterial hypotension, sweating, etc., In the process involved many systems and organs: at the height of acute manifestations of still's disease can develop pleuropneumonia, pleurisy, peri-, endo -, and myocarditis, jade and other blood: hypochromic anemia, neutrophilic leucocytosis (in the later stages leukopenia), accelerated ROHE, the increase of C-reactive protein.
Diagnosis of still's disease in the period deployed symptoms easy. In the absence in the initial phase in some children visible changes from joints of still's disease must be differentiated from rheumatism (see), leukemia (see), some infectious diseases (typhoid, brucellosis, miliary tuberculosis, sepsis). Methods of specific diagnostics are not available.
Treatment - see Arthritis, (non-infectious).
The forecast. The disease resistant, progressive, sometimes due to the development of contractures and deformities of the joints leads to disability. After a few years of the onset of the disease may complete recovery (children with subacute form of still's disease and a more benign course), but often save the changes in the joints. Many patients of still's disease as a consequence of severe metabolic disturbances develops amyloid. Death comes mainly with symptoms of uremia in connection with renal amyloidosis.
Prevention is reduced to the rehabilitation of inflammatory foci, prevention of colds by conducting training measures.