Adult-onset Still’s Disease, a Challenging Diagnosis of Exclusion

Su Hyun Jeong^1, , Nishitha Shekhar¹, Matthew Amin¹, Amir Nabizadeh² and Neelesh Mutyala³

¹University of Nevada Reno, Department of Internal Medicine, Reno, NV

²University of Minnesota, Department of Internal Medicine, Minneapolis, MN

³University of Texas Health Science Center at Houston, Department of Internal Medicine, Houston, TX

Cite this paper:
Su Hyun Jeong, Nishitha Shekhar, Matthew Amin, Amir Nabizadeh and Neelesh Mutyala. Adult-onset Still’s Disease, a Challenging Diagnosis of Exclusion. American Journal of Medical Case Reports. 2023; 11(12):172-175. doi: 10.12691/ajmcr-11-12-2

Abstract

We report a case of Adult-onset Still’s Disease (AoSD) in a 55-year-old male without prior rheumatological history. The disease is an autoinflammatory condition with features including fevers, joint pain, and salmon-colored lesions. Diagnosis is through clinical classification systems including the Yamaguchi or Fautrel criteria and considered after a thorough diagnosis of exclusion. However, the disease is rare and difficult to recognize given its nonspecific presentation. This patient depicts the challenges in noticing the disease, especially in the setting of confounding physical exam findings. Prognosis is favorable, but prolonged periods without treatment can lead to the development of harmful complications including fulminant hepatitis, lymphohistiocytic activation syndrome, and disseminated intravascular coagulation.

Keywords:
adult-onset still's disease yamaguchi criteria fautrel criteria systemic juvenile idiopathic arthritis

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