Acute liver injury in a patient with adult-onset Still's disease-the challenge of differential diagnosis.

In addition to the cardinal symptoms of fever, rash and arthralgia, liver involvement in patients with adult-onset Still's disease (AOSD) has been described. However, acute liver injury in AOSD patients can have various other causes: it can be a result of an AOSD-induced macrophage activation syndrome or be associated to the drugs given for the underlying diseases and symptoms. Differential diagnosis can therefore be challenging. We here present a case of a 32-year-old male with acute liver injury following the initial diagnosis of AOSD to discuss the possible underlying reasons.