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Tests and diagnosis
By Mayo Clinic staffThere's no single test used to diagnose adult Still's disease. Your doctor will likely consider a number of diagnostic tools, because the signs and symptoms of adult Still's disease may mimic those of other conditions, such as mononucleosis, lymphoma or other rheumatic diseases. Your doctor may make a diagnosis based on the following:
- Signs and symptoms. Your doctor might suspect adult Still's disease if a physical exam reveals that you have a high fever, swollen joints and a salmon-pink rash. Swollen lymph nodes and a sore throat also are common.
- Imaging tests. Inflammation of the lining of your heart or lungs may be detected by an echocardiogram. X-rays of your bones may show changes in your wrists, spine, foot or finger joints. A computerized tomography (CT) scan or ultrasound may indicate that your liver or spleen is enlarged.
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Blood tests. A number of blood tests may give an indication that you have adult Still's disease. One type of test measures counts of certain blood cells: Typically, the number of white blood cells and platelets are high, while the red blood cell count is often low (anemia).
Another common blood test for people with inflammatory conditions involves checking your erythrocyte sedimentation rate (sed rate). This test measures how quickly your red blood cells settle when placed in a test tube. Generally, the blood cells fall faster — that is, the sed rate increases — when inflammation is present.
Other blood tests that may show increased levels in adult Still's include C reactive protein (CRP) and ferritin. In adult Still's disease, markedly elevated ferritin levels can be found and some researchers have suggested that ferritin may be helpful for monitoring disease activity during treatment.
Blood tests for rheumatoid factor and antinuclear antibodies (ANA) are usually negative for people with adult Still's disease. In addition, liver function tests can help determine how well your liver is working; in case of adult Still's disease, levels of certain liver enzymes may be elevated.
