eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2022-10-28 10 10 274 276 10.12691/ajmcr-10-10-6 AJMCR202210106 article Irvind Buttar ibuttar1@northwell.edu 1 Elizabeth McCuaig 1 Harry Fischer 2 Erin Patton 2 Internal Medicine, Northwell Health/Lenox Hill Hospital, New York, United States Rheumatology, Northwell Health/Lenox Hill Hospital, New York, United States Adult-onset Still¡¯s disease (AOSD) is a systemic inflammatory disorder. Its clinical presentation is similar to the systemic form of Juvenile idiopathic arthritis (JIA). In this case report we explore a young female 22 years after a diagnosis of JIA and 4 years after her diagnosis of AOSD who presents with systemic inflammatory symptoms. Some of the symptoms consistent with her previous diagnosis and some new. Specifically the new symptom of her diffuse lymphadenopathy lead to a differential of possible lymphoproliferative disease. After a biopsy and multiple admissions with unrelenting symptoms the patient was diagnosed with a flare of AOSD. We explore her case in depth with the question in mind: Does one diagnosed with JIA remain on long term therapy to avoid recurrent flares and progression to AOSD, and if so for how long? http://pubs.sciepub.com/ajmcr/10/10/6/ajmcr-10-10-6.pdf stills disease juvenile idiopathic arthritis lymphadenopathy