Physicians at Burjeel Hospital Abu Dhabi have successfully diagnosed and treated a 34-year-old patient with Adult-Onset Still’s Disease, a rare autoimmune condition estimated to affect between one and four people per million worldwide.
The patient had presented with more than two weeks of persistent high-grade fever, severe joint pain, extreme fatigue, and signs of liver involvement. Routine blood tests and infection screenings at multiple hospitals had returned no conclusive findings, leaving the underlying cause unidentified as his condition continued to deteriorate.
A thorough clinical investigation at Burjeel Hospital eventually pointed to Adult-Onset Still’s Disease, a diagnosis made more challenging by the condition’s tendency to resemble a range of other serious illnesses. Dr. Niyas Khalid, Specialist in Internal Medicine, noted that the disease is frequently mistaken for severe infections, autoimmune disorders, liver disease, and certain cancers, making it particularly difficult to identify in clinical settings where fever is commonly associated with infectious causes.
The absence of a rash, a symptom often associated with the condition in medical literature, added further complexity to the diagnostic process. In this patient’s case, the key indicators were an unusual combination of prolonged fever spiking at regular daily intervals, elevated inflammation markers, liver involvement, and exceptionally high ferritin levels, alongside negative results across all infectious and autoimmune tests. Dr. Khalid described the elevated ferritin reading as the critical diagnostic signal that brought the picture together.
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Left untreated, Adult-Onset Still’s Disease can lead to serious complications including organ damage, chronic inflammatory arthritis, liver failure, and a potentially fatal condition known as macrophage activation syndrome, in which the immune system triggers an uncontrolled inflammatory response.
Once the diagnosis was confirmed, the medical team initiated high-dose corticosteroid therapy, the primary treatment approach for the condition. The dosage was subsequently reduced gradually over several weeks. According to Dr. Khalid, the patient’s fever resolved within 24 hours of beginning treatment, with notable improvements in joint pain and energy levels within 48 hours. Laboratory markers also showed parallel improvement.
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The patient described the period before diagnosis as physically and emotionally exhausting, recounting an inability to move without assistance and recurring fever that persisted despite medication. Following treatment, he expressed relief at regaining independent mobility.
Although the patient has recovered well, ongoing monitoring remains necessary. Adult-Onset Still’s Disease can recur in some individuals, and he will continue regular follow-up with internal medicine and rheumatology specialists to track any signs of relapse and maintain long-term stability.
