{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:34:15Z","timestamp":1782401655786,"version":"3.54.5"},"reference-count":24,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Medicine"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p>Adult onset Still\u2019s disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. It is characterized by daily fevers, arthralgias or arthritis, typical skin rash, and leukocytosis. Hepatic involvement is frequently observed in the course of AOSD with mildly elevated transaminases and\/or hepatomegaly. Fulminant hepatic failure, occasionally requiring urgent liver transplantation, is a rare manifestation of AOSD. Here, we present a case of 22-year-old woman with no significant medical history who initially came with fever, arthralgias, myalgias, generalized weakness, and sore throat. Laboratory data showed mildly elevated transaminases and markedly elevated ferritin levels. She was diagnosed with AOSD based on Yamaguchi diagnostic criteria and was started on prednisone. Three months later, while she was on tapering dose of steroid, she presented with fever, abdominal pain, jaundice, and markedly elevated transaminases. Extensive workup excluded all potential causes of liver failure. She was diagnosed with AOSD associated acute liver failure (ALF). Intravenous (IV) methylprednisolone pulse therapy was started, with dramatic improvement in liver function. Our case demonstrated that ALF can present as a complication of AOSD and IV mega dose pulse methylprednisolone therapy can be employed as a first-line treatment in AOSD associated ALF with favorable outcome.<\/jats:p>","DOI":"10.1155\/2014\/375035","type":"journal-article","created":{"date-parts":[[2014,6,4]],"date-time":"2014-06-04T21:05:14Z","timestamp":1401915914000},"page":"1-5","source":"Crossref","is-referenced-by-count":13,"title":["Rare Manifestation of a Rare Disease, Acute Liver Failure in Adult Onset Still\u2019s Disease: Dramatic Response to Methylprednisolone Pulse Therapy\u2014A Case Report and Review"],"prefix":"10.1155","volume":"2014","author":[{"given":"Nalini","family":"Valluru","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Virginia Commonwealth University, West Hospital, 14th Floor, 1200 East Broad Street, P.O. Box 980341, Richmond, VA 23298, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkata S.","family":"Tammana","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Windham","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyasu","family":"Mekonen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rehana","family":"Begum","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Sanderson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Howard University Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"98","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2008.08.006"},{"issue":"3","key":"2","first-page":"424","volume":"19","year":"1992","journal-title":"The Journal of Rheumatology"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1007\/s00104-012-2314-x"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/j.gastrohep.2009.06.009"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2007.06.025"},{"issue":"10","key":"6","first-page":"2038","volume":"24","year":"1997","journal-title":"The Journal of Rheumatology"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1746.2003.03060.x"},{"issue":"5","key":"8","first-page":"1093","volume":"30","year":"2003","journal-title":"The Journal of Rheumatology"},{"issue":"4","key":"9","first-page":"784","volume":"23","year":"1996","journal-title":"The Journal of Rheumatology"},{"issue":"2","key":"10","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1136\/ard.30.2.121","volume":"30","year":"1971","journal-title":"Annals of the Rheumatic Diseases"},{"issue":"7","key":"11","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1136\/ard.54.7.587","volume":"54","year":"1995","journal-title":"Annals of the Rheumatic Diseases"},{"issue":"4","key":"12","doi-asserted-by":"crossref","first-page":"221","DOI":"10.2188\/jea.7.221","volume":"7","year":"1997","journal-title":"Journal of Epidemiology"},{"issue":"1","key":"13","first-page":"35","volume":"29","year":"2008","journal-title":"Tropical Gastroenterology"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200301000-00015"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1007\/s00063-007-1103-7"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-007-0791-y"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-008-0950-9"},{"issue":"12","key":"18","first-page":"841","volume":"7","year":"2011","journal-title":"Gastroenterology & Hepatology"},{"issue":"2","key":"19","doi-asserted-by":"crossref","first-page":"89","DOI":"10.2169\/internalmedicine.34.89","volume":"34","year":"1995","journal-title":"Internal Medicine"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1269444"},{"issue":"12","key":"21","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.2169\/naika.83.2151","volume":"83","year":"1994","journal-title":"Nippon Naika Gakkai Zasshi"},{"issue":"10","key":"22","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1093\/qjmed\/94.10.568","volume":"94","year":"2001","journal-title":"QJM"},{"issue":"6","key":"23","first-page":"673","volume":"6","year":"1979","journal-title":"The Journal of Rheumatology"},{"issue":"7","key":"24","first-page":"1088","volume":"18","year":"1991","journal-title":"The Journal of Rheumatology"}],"container-title":["Case Reports in Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crim\/2014\/375035.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crim\/2014\/375035.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crim\/2014\/375035.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,22]],"date-time":"2017-06-22T14:21:44Z","timestamp":1498141304000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/crim\/2014\/375035\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014]]},"references-count":24,"alternative-id":["375035","375035"],"URL":"https:\/\/doi.org\/10.1155\/2014\/375035","relation":{},"ISSN":["1687-9627","1687-9635"],"issn-type":[{"value":"1687-9627","type":"print"},{"value":"1687-9635","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014]]}}}