A case with adult still's disease who was treated with indomethacin and review of treatment approaches

Adult Still's disease (ADS) is a rare condition, usually presenting with high fever accompanied by systemic manifestations. Non steroid anti inflammatory drugs (NSAID) and steroids are used for first-line therapy. In patients that are nonresponsive to this therapy or those that require high dose steroid, disease-modifying antirheumatic drugs such as methotrexate (MTX), gold salts, cyclophosphamide, cyclosporine- A and azathioprine (AZA) can be used. The efficacy of interleukin 1 (IL -1) inhibitors and tumor necrosis factor-alpha (TNF alpha) blockers in chronic inflammatory disease like rheumatoid arthritis, ankylosing spondylitis and juvenile chronic arthritis is pointed. Recently studies show that these agents can be used successfully also in the patients who are resistent for conventional therapy. Here, it is aimed to investigate the new and conventional treatment approaches of ASD in the light of literature via presentation of a 51 year old female case with ASD that was treated with indomethacin.