Systemic-Onset JIA

Historically, SoJIA was called Still’s Disease.  Many older physicians continue to use that terminology.  This disease was first described in 1896 by an English pediatrician, Sir George Fredric Still.  Doctor Still’s doctoral thesis was published in 1897, and described a childhood arthritis characterized by joint pain, fevers, and a salmon-colored rash.

What was originally considered Still’s Disease and was later known as systemic-onset JRA, is now classified as Systemic-Onset Juvenile Idiopathic Arthritis.

Adult-Onset Still’s Disease

In 1971, a British rheumatologist, Eric George Lapthorne Bywaters, noted that some adults had a disease similar to Still’s (systemic onset JIA), but that their disease didn’t meet the criteria for a diagnosis of rheumatoid arthritis.  The disease is relatively rare and hard enough to recognize that it was featured in Dr. Lisa Sanders’ book, Every Patient Tells a Story.

When discussing Still’s, it’s important to distinguish the age when the patient was first afflicted.  The cut-off is age sixteen.  Older, it’s adult-onset Still’s; younger, it’s systemic-onset JIA.

Treatment

There is no cure for either the juvenile or adult versions of this disease.  There are treatments, though.

Historically, aspirin or NSAIDs were the only treatment available.  In time it was discovered that corticosteroids (such as prednisone) can be effective in reducing the inflammation of this disease, but should not be used indefinitely since long-term steroid use can be bad.

In 1988, methotrexate was FDA approved as an RA treatment, and over time it has been used to treat other autoimmune diseases, too.  Other DMARDs that have proven effective in treating other forms of autoimmune arthritis can also be effective in treating people with SoJIA.

Additionally, there are stronger medications (known as biologics) that can be very effective if the older DMARDs don’t provide enough relief.

For Further Reading

Adult Still’s Disease
Juvenile Rheumatoid Arthritis

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