Atypical adult-onset Still’s disease with an initial and sole manifestation of liver injury: A case report and review of literature

Adult-onset Still’s disease with hepatomegaly

“…Hepatomegaly is reported in a minority of patients; the frequency in different studies ranges from 12 -45% whereas elevations of transaminases seem to be common. Rarely liver failure can occur in Still's disease and hepatic involvement can be a presenting feature as well (1,4).…”

Clinicopathologic Features of Adult-onset Still's Disease Complicated by Severe Liver Injury

“…However, the pathogenesis and mechanism of liver injury are unknown and yet to be elucidated. The histopathological findings of liver injury complicated with AOSD have been reported to be (1) periportal inflammatory infiltrates, (2) periportal fibrosis, (3) Kupffer cell hyperplasia, and (4) focal hepatitis with submassive necrosis; however, none of these findings is specific to AOSD ( 7 - 9 ). Liver injury complicated with AOSD can be caused by drug-induced liver damage associated with treatment or other coexisting liver diseases; thus, its diagnosis requires a careful review of the clinical course, discontinuation of suspected drugs, and exclusion of other liver diseases.…”