Adult onset still’s disease: a diagnostic dilemma


  • Dugganapalli Dinesh Kumar Reddy Department of Medicine, Rangaraya Medical College, Kakinada, Andhra Pradesh, India
  • Veeraballi Sindhusha Department of Medicine, SV Medical Vollege, Tirupati, Andhra Pradesh, India
  • Metta Jagadeesh Department of Medicine, Rangaraya Medical College, Kakinada, Andhra Pradesh, India



Adult onset still’s disease, Arthritis, Evanescent rash, High spiking fever, Pyrexia of unknown origin


Adult onset still’s disease is a rare systemic inflammatory disorder of unknown aetiology, characterized by clinical triad (high spiking fever, evanescent rash and arthritis) and biological triad with lack of serological markers as a true gold standard makes diagnosis difficulty. Here is a case of 32year old male presented with high grade fever for 2 months, joint pains and swelling for 1month rash for 3 days. O/E: pallor and B/L tender, swollen ankle and knee joints, and P/A: splenomegaly. Investigations showed-Hb%. 8 gms, neutrophilic leucocytosis with thrombocytosis, ESR:72 mm/1h, CRP elevated. ASO-titre, RA factor and Anti CCP antibodies are negative. Adult onset still’s disease is a heterogenous and rare systemic inflammatory disorder of unknown aetiology with lack of serological diagnostic modalities.


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