Adult-onset Still’s disease, an uncommon form of inflammatory arthritis, is usually diagnosed in childhood. However, it’s possible to develop Still’s as an adult. Securing life insurance when you have Still’s can be complicated.
Contact Rheumatoid Arthritis Life Insurance for an in-depth consultation. We’re experts in helping people with rheumatoid arthritis, regardless of the type, find the highest quality life insurance policy they can be approved for.
Adult-onset Still’s Disease Overview
Named after George F. Still (1861 – 1941), an English physician, Adult-onset Still’s disease is usually considered one type of Juvenile Rheumatoid Arthritis (JRA).
It’s also known as SOJIA, or systemic-onset idiopathic arthritis. The term idiopathic refers to the fact that the origin and cause of the condition is unknown.
Still’s is also considered a systemic condition because it affects the entire body. As an adult, the condition is referred to as, AOSD, or adult-onset Still’s disease.
Adult Still’s disease is a rare type of inflammatory arthritis that features fevers, rash and joint pain. Some people have just one episode of adult Still’s disease. In other people, the condition persists or recurs. –Mayo Clinic
Adult-onset Still’s disease is so uncommon that fewer than 1 in 100,000 people are diagnosed with it each year. Women are affected more often than men.
Causes of Still’s
Unfortunately, it is unknown what causes Adult-onset Still’s disease. There are a few schools of thought on what might potentially trigger it.
For example, some physicians have found a potential connection between a viral or bacterial infection and the onset of Still’s. Other medical experts theorize that Still’s occurs in people with a hypersensitive immune system.
Symptoms of Adult-onset Still’s Disease
- Fever – A fever that quickly appears and is typically over 102 F. It tends to last for a week or longer. Often, the fever spikes in the afternoon or evening.
- Rash – A salmon-colored rash often appears and disappears with the fever. The rash usually is seen on your arms, legs, or trunk.
- Sore Throat – Sore throat is often the first sign of Still’s. The lymph nodes surrounding your neck may be tender or swollen.
- Achy and Swollen Joints – Warm, swollen, achy joints is common. Multiple joints are usually involved, like wrists, elbows, knees, and shoulders. It usually lasts 2 weeks or longer.
- Muscle Pain – Muscle pain is routinely associated with fever. The pain is often strong enough to disrupt daily activity.
Most complications from adult Still’s disease arise from chronic inflammation of organs and joints.
Diagnosis of Still’s
There is not a specific test to diagnose Still’s. Physicians use imaging and blood work results to rule out other conditions and confirm Still’s.
According to the National Institutes of Health (NIH), the following tests are helpful in diagnosing Still’s.
- Complete Blood Count (CBC) – often will show a low number of red blood cells and an elevated number of white blood cells.
- C-Reactive Protein – a marker in the blood that indicates chronic inflammation. It tends to be higher in those with Still’s.
- ESR (Erythrocyte Sedimentation Rate) – also indicates inflammation and will be elevated in Still’s.
- Ferritin – a blood cell that contains iron. Ferritin levels tend to be very high and indicate inflammation.
- Fibrinogen – a blood plasma protein made in the liver. Also called Factor 1, it aids in blood coagulation. Levels will be elevated.
- Liver Function Tests – a liver panel of your AST and ALT will be elevated. One rare complication, macrophage activation syndrome, can lead to serious liver problems.
- Rheumatoid Factor and ANA (antinuclear antibody) – both of these tests will be negative.
- Imaging – Ultrasound or CT scan of the abdomen. X-rays of the joints and chest. Imaging can show inflammation or damage to the joints.
Treatment Options For Still’s
Depending on the severity of Still’s, treatment options will vary. Drug treatments are similar to RA.
- NSAIDS – Non-steroidal anti-inflammatory drugs reduce inflammation, fever and pain. Over the counter NSAIDS include ibuprofen (Motrin IB, Advil) and naproxen sodium (Aleve). Prescription strength NSAIDS are also available.
- Steroids – Reduce acute symptoms of inflammation and pain. Physicians often prescribe corticosteroids, such as Prednisone, temporarily to treat pain and swelling with the goal to eventually taper off steroids.
- Disease-modifying Antirheumatic Drugs – In addition to treating symptoms, DMARDS (such as Methotrexate, Rheumatrex, Arava, Plaquenil, and Azulfidine) have shown to be highly effective at slowing the progression of RA. Joint and tissue health can be preserved.
- Biologic agents – Considered a newer class of DMARDS (Orencia, Humira, Kineret, etc.), these medications are biologic response modifiers. Biologic agents can target specific areas of the immune system to combat inflammation.
For about 1 in 5 people, the symptoms of Still’s disappear and, thankfully, never return. Others experience a waxing and waning of symptoms over a period of a few years.
Still’s Factors Affecting Life Insurance
Life insurance carriers will ask you essentially the same questions for Adult-onset Still’s Disease as they would for RA.
- Date of diagnosis – because Adult-onset Still’s Disease has the potential to be a chronic condition, insurance companies want to know how long you have been treating it. Their concern is the longterm effects drugs used for the management of Still’s has on the body.
- Duration and frequency of Still’s flareups – the more often you have flareups, and how long they last, increases your risk for joint and tissue damage.
- Deformity – insurance companies want to know if you have (and what type) a deformity. For example, a mild deformity of the wrists or fingers or a major deformity of the knees or hips.
- Disability – the inability to live independently and perform the daily activities of living, due to a disability, adversely affects your life insurance rating. Social Security Disability Insurance exists for people facing such a challenge.
- Parts of body affected – areas of the body, and to what degree they are affected by Still’s. For example, mild wrist pain or lung and heart damage.
- Medication – how often and what type of drugs used in your treatment plan.
Can I Be Approved For Life Insurance With Still’s?
The short answer is, yes! The long answer is, yes, but your approval and the amount of premium (money you pay in exchange for life insurance) depends on a number of factors.
Often, you can be approved for traditional, fully-underwritten life insurance with Adult Still’s Disease.
The approval is dependent on the Still’s factors we discussed affecting life insurance: date of diagnosis, duration and frequency of Still’s flareups, deformity, disability, parts of the body affected, and medications used.
Let’s consider three possible outcomes for a life insurance application with Adult Still’s Disease:
- Standard Approval – ideal situation. In order to be approved at standard rates, your Still’s will need to be well-controlled with mild medications, like NSAIDS (non-steroidal anti-inflammatory drugs). Well-controlled Still’s Disease means minimal flare-ups of joint pain and swelling, no evidence of organs affected, no disability, and documented regular check-ups with your physician.
- Rated Approval – mild/moderate Still’s. Insurance carriers will be looking for longterm treatment with medications such as steroids and DMARDS, a mild deformity, and/or mild disability. A rated approval means you still qualify for life insurance, but will have a premium surcharge of somewhere between 25 – 200%.
- Decline – severe Adult Still’s Disease. If primary organs are involved, major deformity, and/or the inability to perform daily tasks independently have occurred, a decline of standard life insurance is usually the result. In this case, we can examine if a graded death benefit life insurance policy makes sense.
Additionally, there are factors unrelated to arthritis that can impact your ability to be approved for traditional life insurance.
For example, life insurance carriers will want to put a magnifying glass on any of these topics:
- Overweight or Obese
- Elevated Cholesterol, Lipids, or Triglycerides
- Elevated Liver Function
- Elevated Blood Sugar
- Hazardous Occupation
- Hazardous Hobbies
- Drug Use
- Driving Record
- History of Cancer
- Criminal Record
Apply For Life Insurance With Still’s
We specialize in working with clients with Still’s, and other forms of rheumatoid arthritis, find the highest quality protection at the best prices available.
If you have Adult Still’s Disease and are seeking out life insurance, it’s crucial to collaborate with an agent with a deep understanding of inflammatory arthritis.
At Rheumatoid Life Insurance, our job is to be your advocate. As an independent life insurance agency, we will cross-reference the top-rated life insurance companies to find the best rate for which you can be approved.
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