Still's Disease

Adult Still's disease can only be diagnosed after other diseases are ruled out. You may need many medical tests before a final diagnosis is made.

A physical exam may reveal a fever, rash, and arthritis. The health care provider will use a stethoscope to listen for changes in the sound of your heart or lungs.

The following blood tests can be helpful in diagnosing adult Still's disease:

Complete blood count (CBC) may show a high number of white blood cells and reduced number of red blood cells. A complete blood count (CBC) test measures the following:

  • The number of red blood cells (RBC count)
  • The number of white blood cells (WBC count)
  • The total amount of hemoglobin in the blood
  • The fraction of the blood composed of red blood cells (hematocrit)

The CBC test also provides information about the following measurements:

  • Average red blood cell size (MCV)
  • Hemoglobin amount per red blood cell (MCH)
  • The amount of hemoglobin relative to the size of the cell (hemoglobin concentration) per red blood cell (MCHC)

The platelet count is also usually included in the CBC.

C-reactive protein (CRP), a measure of inflammation, will be higher than normal. C-reactive protein is produced by the liver. The level of CRP rises when there is inflammation throughout the body.

ESR (sedimentation rate), a measure of inflammation, will be higher than normal. ESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate." It is a test that indirectly measures how much inflammation is in the body.

Ferritin level will be very high. Ferritin is a protein found inside cells that stores iron so your body can use it later. A ferritin test indirectly measures the amount of iron in your blood. The amount of ferritin in your blood (serum ferritin level) is directly related to the amount of iron stored in your body.

  • Fibrinogen level will be high.
  • Liver function tests will show high levels of AST and ALT.
  • Rheumatoid factor and ANA test will be negative.

AST (aspartate aminotransferase) is an enzyme found in high amounts in liver, heart, and muscle cells. It is also found in lesser amounts in other tissues.

Alanine transaminase (ALT) is an enzyme found in the highest amounts in the liver. Injury to the liver results in release of the substance into the blood.

Enzymes are complex proteins that cause a specific chemical change in all parts of the body. For example, they can help break down the foods we eat so the body can use them. Blood clotting is another example of enzymes at work.

Enzymes are needed for all body functions. They are found in every organ and cell in the body, including in the:

  • Blood
  • Intestinal fluids
  • Mouth (saliva)
  • Stomach (gastric juice

Rheumatoid factor (RF) is a blood test that measures the amount of the RF antibody in the blood. An antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include microorganisms (such as bacteria, fungi, parasites, and viruses) and chemicals.

Antibodies may be produced when the immune system mistakenly considers healthy tissue a harmful substance. This is called an autoimmune disorder. An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. There are more than 80 different types of autoimmune disorders

Normally the immune system's white blood cells help protect the body from harmful substances, called antigens. Examples of antigens include bacteria, viruses,toxins, cancer cells, and blood or tissues from another person or species. The immune system produces antibodies that destroy these harmful substances.

In patients with an autoimmune disorder, the immune system can't tell the difference between healthy body tissue and antigens. The result is an immune response that destroys normal body tissues. This response is a hypersensitive reaction similar to the response in allergic conditions.

In allergies, the immune system reacts to an outside substance that it normally would ignore. With autoimmune disorders, the immune system reacts to normal body tissues that it would normally ignore.

What causes the immune system to no longer tell the difference between healthy body tissues and antigens is unknown. One theory is that some microorganisms (such as bacteria or viruses) or drugs may trigger some of these changes, especially in people who have genes that make them more likely to get autoimmune disorders.

An autoimmune disorder may result in:

  • The destruction of one or more types of body tissue
  • Abnormal growth of an organ
  • Changes in organ function

An autoimmune disorder may affect one or more organ or tissue types. Organs and tissues commonly affected by autoimmune disorders include:

  • Blood vessels
  • Connective tissues
  • Endocrine glands such as the thyroid or pancreas
  • Joints
  • Muscles
  • Red blood cells
  • Skin

Toxins are substances created by plants, animals and man that are poisonous to humans. Toxins also include medications that are helpful in small doses but poisonous when used in large amounts. Toxins also include environmental substances such as mercury, lead, phthalates, 

Most toxins that cause problems in humans are released by germs such as bacteria. For example, cholera is due to a bacterial toxin. Lyme Disease is a bacterial spirochete called Borelia Burgdoferi. Lyme spirochete resembles Syphilis spirochete. 

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