Do you sometimes feel achy, feverish, and sore joints for days? Maybe with a pink rash on your skin. If you have these symptoms, you may have what we're talking about today: Adult-Onset Still's Disease (AOSD). This is a rare condition, but it's important to be aware of it.
What is Adult-Onset Still's Disease (AOSD)?
Simply put, AOSD is an inflammatory arthritis that affects the entire body, causing swelling and pain in the joints . It can cause joint pain, muscle pain, fever that comes and goes throughout the day, and a skin rash. In addition, other systemic symptoms can also occur.
This disease, called `AOSD`, is an adult form of the disease `Still's disease` or `(Juvenile Idiopathic Arthritis - JIA)` that occurs in children. It most often affects young people between the ages of 16 and 35. Like the disease in children, it can sometimes last less than a year and then disappear, or it can come and go over time. Symptoms ``flares`` can come and go frequently, or they can come and go for a long time. Also, these symptoms can sometimes be very mild, and at other times they can be very severe. However, there are good medications to control symptoms when they do appear.
What are the main types of this disease?
AOSD affects everyone differently. It's hard to say exactly how it will affect you. But doctors have observed that symptoms usually manifest in three main ways:
Monophasic AOSD `(Monophasic AOSD)`
"Monophasic" means that the symptoms appear only once . This can last for a few weeks or months, but less than a year. This type can start suddenly, and also disappear quickly. Imagine, our friend Kasun had these symptoms with fever and joint pain, and after about three months he got completely better with medication, and he never came back. That's what this `(Monophasic AOSD)` is called.
Polyphasic AOSD `(Polyphasic AOSD)`
"Polyphasic" means that symptoms occur multiple times . These may occur intermittently, sometimes every few weeks, months, or even years. However, over time, these symptoms often become shorter and less severe.
Chronic AOSD `(Chronic AOSD)`
"Chronic" means that you have ongoing symptoms, or that the condition flares up frequently . As with diseases like Rheumatoid Arthritis, this condition (Chronic AOSD) is more likely to cause long-term damage to your joints.
All three types are seen in more or less the same proportion. However, it is not possible to say exactly which type it is at the beginning. Sometimes, even if it is thought to be "monophasic" or "polyphasic", it can later become "chronic" `AOSD`.
What are the symptoms of AOSD?
In addition to the main symptoms seen in this disease, there are other common symptoms.
Main symptoms
- Fever: When symptoms are active, most people have a fever twice a day , once in the morning and once in the evening. This fever can usually be higher than 39 degrees Celsius (102 degrees Fahrenheit).
- Skin rash: A pink, sometimes salmon-colored rash usually appears during the peak of a fever . It may disappear when the fever subsides. It usually appears on the chest, arms, and legs at first, but can spread throughout the body.
- Joint pain: Many people experience joint pain , and many may also experience swelling and stiffness. It may initially affect just a few joints, but over time, this pain can affect the joints throughout the body.
- Muscle pain: Your muscles may also feel sore , especially when the fever is at its highest.
Other common symptoms
- Sore throat.
- Stomach ache.
- Feeling of extreme fatigue.
- Malaise is a feeling of malaise, a feeling of unwellness.
How does it feel to have AOSD?
In fact, at first, AOSD feels like a viral illness or a common cold . Symptoms like fever, body aches, and sore throat are similar to many other common illnesses. You and your doctor may start to get a little suspicious if these symptoms haven't subsided after two to three weeks.
Why does this AOSD disease occur?
Inflammation in your body is what causes the symptoms of AOSD . Normally, our immune system causes this inflammation to fight infections and heal wounds. It should really be temporary. But in some diseases, like AOSD, your immune system has a problem with something , and it keeps causing this inflammation even when there is no infection to fight or wound to heal.
Researchers still don't know exactly why this happens. Like Juvenile Idiopathic Arthritis, Adult Still's Disease is called " idiopathic ." That means the exact cause is unknown . It doesn't seem to be genetic.
How is AOSD diagnosed?
The symptoms of AOSD are similar to many other conditions. And because it's a rare condition, doctors may not suspect it at first. So it can take some time to get an accurate diagnosis .
After reviewing your symptoms and medical history, your doctor will order blood tests and imaging tests to learn more about your condition. Tests such as X-rays or ultrasound scans can look for inflammation and swelling in your joints. Blood tests can rule out other conditions. If your blood test shows a very high level of ferritin, along with a high white blood cell count , these symptoms may indicate AOSD.
What are the treatments for AOSD?
Doctors treat AOSD with a variety of anti- inflammatory drugs . The types of drugs that work best for each person are different. It may take some experimentation to find the one that works best for your symptoms. Once you find the right one, you may need to continue taking the medication for a long time, even when you don't have symptoms. Only then can you stop the inflammation from getting worse.
Some medications can cause side effects if used for a long time. If you are taking such medications, your doctor will occasionally change the medications to avoid side effects.
Some of the medications used for treatment are:
- Nonsteroidal anti-inflammatory drugs (NSAIDs).
- Corticosteroids (synthetic steroids) `(Corticosteroids - synthetic steroids)`.
- Disease-modifying anti-rheumatic drugs (DMARDs).
- Biological drugs `(Biologics)`.
How serious is AOSD?
In most cases, AOSD affects your quality of life more than your long-term health . That is, it may cause discomfort and interfere with daily activities, but it is not necessarily harmful to your body in the long term.
However, some people can develop a progressive, degenerative form of arthritis . This is more likely to occur in chronic AOSD than in other types. If the inflammation in your joints is severe enough and lasts a long time, they can gradually wear away. As the cushioning around your joints wears away due to inflammation, your joints can begin to move out of place. This swelling and joint degeneration can lead to painful deformities in your joints.
Very rarely, the inflammatory conditions associated with AOSD can also affect your internal organs, such as your heart and lungs. This can lead to more serious complications. While AOSD itself may not affect your lifespan, these secondary conditions can rarely be fatal.
What serious complications can occur?
Rare but serious complications include:
- Pericarditis.
- Myocarditis.
- Disseminated intravascular coagulopathy (DIC).
- Pulmonary arterial hypertension.
- Pleural effusion.
- Interstitial lung disease.
- Hemophagocytic lymphohistiocytosis (HLH).
Can AOSD be completely cured?
Medications cannot cure AOSD, but they can help suppress the symptoms. For some people, symptoms may go away completely over time and never come back. This is called going into "remission," or the disease becoming quiet. If you go into "remission," you can stop taking your medication. But for some people, AOSD never really goes away. They may need to take medication indefinitely to control the inflammation.
It's hard to say exactly what kind of condition you can expect. However, some doctors believe that your early symptoms can give you a clue . If you have pain and swelling in your joints early on, it's more likely to last a long time.
How should we take care of ourselves while living with AOSD?
Many people living with AOSD can live normal, comfortable lives with the right medication . For others, they struggle with occasional chronic pain and chronic fatigue, which can affect their daily lives. Whether or not the symptoms of AOSD continue to bother you, you may experience side effects from the medication you take, such as weight gain and mood swings.
When life is constantly stressful due to things you can't control, it's even more important to take care of basic self-care . Good quality sleep, a nutritious diet, and regular, low-impact exercise can help you feel better overall.
AOSD is a mysterious condition that comes on suddenly and for no known reason. When it first occurs, you may feel unusually ill for a long time. It may take your doctor some time and effort to figure out what is going on. Fortunately, once you are diagnosed, you can start treatment and gradually start to get better.
Although it may take some trial and error to find the treatment that works best for you, most people can manage their symptoms and prevent serious complications with medication . No matter how long you have AOSD, your doctor will be your best partner in managing it.
Finally, take-home message
- AOSD is a rare inflammatory joint disease that affects the entire body and occurs in adults.
- Frequent fever, skin rash, and joint and muscle pain are the main symptoms.
- The exact cause of this is not known, but it is primarily due to inflammation caused by changes in the functioning of the immune system.
- It can take a while to diagnose, because the symptoms are similar to other diseases.
- Medication can help control symptoms and , for some, even completely cure the disease.
- With the right treatment and good self-care, most people can live a normal life.
- If you have these symptoms, definitely see a doctor and get advice . Don't worry, there are solutions to everything.
Wishing you good health!
` Adult Still's disease, AOSD, arthritis, fever, skin rash, autoimmune diseases, treatment
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