ADULT-onset STILL’ s DISEASE (AOSD) is an uncommon inflammatory condition presenting with high grade fever, arthralgia, skin rash, and leukocytosis. Autoimmune thyroid DISEASE (AITD) is commonly seen in females in their third to fifth decade and usually missed to screen in other autoimmune DISEASEs. In this study, the case of a 17-year-old female patient from Pune is reported who presented to Bharati hospital in November 2020, with a six-month history of high-grade fever, arthritis, and elevated acute phase reactants along with hypothyroidism. She was diagnosed with AOSD (based on Yamaguchi criteria) and AITD with positive anti-thyroid peroxidase (anti-TPO) antibodies. She responded well to oral steroids and thyroid supplements. This case draws attention to the rare association between AOSD and AITD.

ADULT-onset STILL DISEASE (AOSD) is a rare rheumatologic condition with unrecognized etiology. Spiking fevers, joint involvement (arthralgia or arthritis), rashes, lymphadenopathy, abnormal liver function test data, and leukocytosis are the main features of this DISEASE. Yamaguchi’ s criteria with the sensitivity and specificity of 96. 2% and 92. 1%, respectively, is the most beneficial tool for the diagnosis of AOSD, as a rare DISEASE. The uncommon features of the STILL DISEASE remain confusing for clinicians. about the present study reported a 27-year-old patient who was referred to our hospital with an unknown diagnosis, because of the rare features of STILL DISEASE. The explored characteristics of rashes, fever, and para-clinical data, as well as laboratory and imaging data, are described in detail; such features have led to long hospitalization to confirm the diagnosis in this patient. The positive family history of the rheumatologic DISEASE and dramatic response to low dose corticosteroids were other outstanding features of our case. This report highlighted the necessity of conducting randomized clinical trials to address the management of AOSD. Besides, the present study signified the need for providing further awareness among clinicians to prevent long hospitalization.

ADULT Onset STILL’ s DISEASE (AOSD) is a rare systemic inflammatory DISEASE of unrecognized etiology and pathogenesis that presents in 5% to 10% of patients as Fever of Unknown Origin (FUO) accompanied by systemic manifestations. We reported a compelling case of a 39-year-old African male who presented with a one-month duration FUO along with skin rash, sore throat, and arthralgia. After an extensive workup, potential differential diagnoses were ruled out, and the patient was diagnosed with AOSD based on the Yamaguchi criteria. After the application of Ultrasound (US) and exercises on both ankles as well as left knee, left elbow, and left wrist, there was an improvement of Visual Analogue Scale by 66. 6%, Five Repetition Sit to Stand Test (FRSTS) improved 50%, Timed Up and Go (TUG) test improved 87. 5%, and there was also an improvement in the 36-Item Short Form Survey (SF-36), and muscle testing. This result was due to the anti-inflammatory effect of the US, leading to decrease pain and improve function in the individuals

Background: Fever of Unknown Origin (FUO) is defined as temperatures of >38/3°c and duration of fever of > 3 weeks with failure to reach a diagnosis despite 1 week of inpatient investigation. Case report: A 20 year-old man presented with FUO and skin rash from 3 weeks ago. Physical examination revealed cervical adenopathy, decreased sound of heart, splenomegaly with generalized maculopapular rash. Echocardiography study revealed pericarditis. In abdominal sonography, splenomegaly and in laboratory test leukocytosis with CRP3+, increased liver function test, increased ferritin and other serologic study was normal. In this case with above findings, ADULT onset STILL DISEASE was diagnosed.Conclusion: Although rare, ADULT onset STILL DISEASE can manifest as Fever of unknown origin and if diagnosed rapidly, it would be possible to prevent joint deformity.

Introduction. This fascinating disorder is also known as Sinus Histiocytosis. It is very rare, probably less than 1000 cases reported in the literature. R.D.D affects lymph nodes, although extranodal involvement has been reported such as: Centaral nervous system (CN.S). All of the cases of R.D.D with CN.S involvement without other sites involvement are 11 cases. Methods. The case is a male patient, 26y/o, with a history of head trauma 2 years ago that has been resulted to unconsciousness. He has been referred to a hospital and brain CT scan and brain M.R.I has been done for him. In M.R.I a brain tumor with left orbit and sphenoidal sinus involvement and compression effect on frontal lobe has been seen. A neurosurgeon operated him and the pathological report was Rosai-Dorfman DISEASE. Then he was referred to radiation therapy department.Results. Treatment approach in CN.S involvement cases consists of surgery, radiotherapy and chemotherapy. Discussion. Over all, response has been inferior to those expected with malignant hematopoietic neoplasms.