Still's arthritis in adults: disease or syndrome?

Seven adults with a syndrome similar to systemic-onset (Still's) juvenile rheumatoid arthritis are reported. In addition to characteristic fever, rash, and arthritis prominent features included pharyngitis (7), lymphadenopathy (6), pleuropericarditis (4) and progression to joint damage (5). Three were over 50-years-old. Previous reports are reviewed. Symptoms, laboratory and physical findings are broadly comparable to the childhood disease. However findings may be quite variable in individual patients and the diagnosis remains a clinical one. Recognition of the variable presentations of this syndrome will assist in the differential diagnosis of fever of unknown origin.