Recurring Lower Abdominal Pain and Fever as Initial Presentation of Adult Onset Still’s Disease in the Absence of Arthralgia and Other System Involvement
  • Abuajela Sreh
    Acute Internal Medicine Department, Walsall Manor Hospital, Walsall
  • Nithyananda Rajaiah
    Acute Internal Medicine Department, Walsall Manor Hospital, Walsall
  • Mohammad Saim
    Acute Internal Medicine Department, Walsall Manor Hospital, Walsall


Adult Onset Still’s Disease, AOSD, fever of unknown origin, pyrexia, abdominal pain


A 34 year-old Afro-Caribbean female presented with recurring episodes of fever and lower abdominal pain over a period of two months not improving despite courses of antibiotics for possible recurrent urinary tract infections. On admission to hospital, patient was treated for a possible pyelonephritis or pelvic inflammatory disease (PID). Extensive investigations into possible source of infection were carried out. However, all of the repeated microbiological cultures were normal. Patient was investigated further for other possible causes including connective tissue disease, haematological disorders, or neoplasm, all of which were normal. Diagnosis of adult onset Still’s disease (AOSD) was confirmed by a rheumatologist based on Yamaguchi’s diagnostic criteria for AOSD alongside significantly raised serum ferritin. Patient was treated with steroids to which she showed remarkable clinical improvement alongside marked reduction in her serum ferritin levels.



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    This figure shows the patient’s persistent pyrexia and other vital signs over the first five days of her admission. downloads: 0

    Published: 2017-08-29
    Issue: Vol. 4 No. 6 (view)

    How to cite:
    Sreh A, Rajaiah N, Saim M. Recurring Lower Abdominal Pain and Fever as Initial Presentation of Adult Onset Still’s Disease in the Absence of Arthralgia and Other System Involvement. EJCRIM 2017;4 doi:10.12890/2017_000619.

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