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Case Report | Medicine | Volume 15 Issue 6, June 2026 | Pages: 796 - 801 | India
A Diagnostic Challenge in Adult-Onset Still's Disease Presenting with Bilateral Pleural Effusions: A Case Report
Abstract: Adult-onset Still's disease (AOSD) is a rare systemic autoinflammatory disorder characterized by fever, arthralgia, rash, leukocytosis, and hyperferritinemia. Owing to its heterogeneous clinical presentation and lack of specific diagnostic biomarkers, it remains a diagnosis of exclusion. Serosal involvement is an uncommon manifestation and may mimic infectious, autoimmune, or malignant diseases, resulting in diagnostic uncertainty and delayed recognition. We report a patient who presented with prolonged fever, constitutional symptoms, and evidence of multisystem involvement, including pleural effusion. Extensive evaluation excluded infectious, malignant, and autoimmune causes. Laboratory investigations revealed significant systemic inflammation, hematological abnormalities, liver function derangement, and markedly elevated serum ferritin levels. Despite comprehensive diagnostic workup, no alternative etiology was identified. In the context of persistent fever, hyperferritinemia, serositis, and exclusion of other causes, a diagnosis of adult-onset Still's disease was established. Treatment with corticosteroids resulted in rapid clinical improvement, resolution of serosal manifestations, and normalization of inflammatory parameters. This case underscores the importance of considering adult-onset Still's disease in patients presenting with prolonged fever, unexplained serositis, and marked hyperferritinemia after exclusion of more common etiologies. Early diagnosis and prompt initiation of immunosuppressive therapy can lead to favorable outcomes and help prevent disease-related complications.
Keywords: Adult-onset Still's disease, Hyperferritinemia, Serositis, Pleural Effusion, Prolonged Fever
How to Cite?: Dr. Dharitri S., Dr. Mujeeb Rahman P. C., Dr. Vijay Krishnan J., "A Diagnostic Challenge in Adult-Onset Still's Disease Presenting with Bilateral Pleural Effusions: A Case Report", Volume 15 Issue 6, June 2026, International Journal of Science and Research (IJSR), Pages: 796-801, https://www.ijsr.net/getabstract.php?paperid=SR26614200135, DOI: https://dx.doi.org/10.21275/SR26614200135