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Adult-onset Still's disease(AOSD) is a rare systemic inflammatory condition that usually develops in young or middle-aged adults. It is characterized by high spiking fevers, painful swollen joints, and a distinctive salmon-pink rash that often appears during fever episodes. The disease can also cause sore throat, enlarged lymph nodes, liver or spleen enlargement, and significant fatigue. Although the exact cause is unknown, AOSD is considered an autoinflammatory disorder in which the immune system becomes excessively activated, producing widespread inflammation.

Diagnosis is challenging because no single test confirms the disease. Doctors rely on symptoms, physical examination, blood tests showing elevated inflammatory markers such as ferritin, and the exclusion of infections, cancers, and other autoimmune diseases. Very high ferritin levels are commonly associated with active disease.

Treatment aims to control inflammation and prevent complications. Nonsteroidal anti-inflammatory drugs may help mild cases, while corticosteroids are often needed for significant symptoms. For persistent or recurrent disease, disease-modifying medicines such as methotrexate or biologic therapies targeting inflammatory pathways, including interleukin-1 or interleukin-6, may be prescribed.

The course of AOSD varies considerably. Some people experience a single episode followed by complete recovery, while others develop recurrent attacks or chronic arthritis. Regular medical follow-up is important because severe inflammation can occasionally lead to serious complications, including macrophage activation syndrome, requiring urgent treatment.