Which organs can be affected by Still’s disease?
It is characteristic of Still’s disease that internal organs are also affected in addition to the joint involvement. Various organs can become inflamed during the course of the disease and thus lead to complaints. The peritoneum (peritonitis), the pericardium (pericarditis) and the lung skin (pleuritis) are most frequently affected by the inflammatory reaction.
Possible symptoms are accordingly abdominal pain, heart complaints or pain when taking deep breaths. Enlargement of the spleen and liver is also common. However, this enlargement is not due to a direct inflammatory involvement of these organs. In rare cases of Morbus Still in adults, an inflammatory involvement of the meninges (meningitis) may occur.
Treatment of Still’s disease
There is no causal therapy that can cure Still’s disease. However, there are numerous drugs that can help prevent or at least minimize damage to joints and organs that would result from the constant inflammation. Such anti-inflammatory therapy is particularly essential for children who are still in the growth process, as otherwise permanent movement restrictions or malpositions may occur.But of course, anti-inflammatory therapy also plays an important role for adults in maintaining quality of life.
Drugs used to treat Still’s disease are non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen or diclofenac, glucocorticoids such as prednisolone or so-called basic therapeutics or disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate, sulfasalazine or azathioprine. In most cases, a treatment attempt with NSAIDs is made for a few weeks at the beginning, as these are the drugs with the fewest serious side effects. If no sufficient improvement can be achieved, drugs from one of the other groups are used.
Although glucocorticoids are often highly effective, they are always administered as briefly as possible in long-term therapy, if possible, due to their numerous adverse effects. It is often necessary to start a therapy with glucocorticoids first until the effect of the basic therapeutics has set in. These have a delayed onset of action of a few weeks to 3 months.
They must often be administered over several years. As a relatively new therapeutic option for Still’s disease, so-called biologicals such as anakinra are becoming increasingly important. These are antibodies that bind to certain receptors or mediators of the inflammatory reaction and thus lead to an inflammation inhibition. In addition to drug therapy, regular physiotherapy and occupational therapy play an important accompanying role, especially in juvenile Still’s disease. You can find more information about the individual medications under
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