Adult-onset Still’s disease in an elderly woman with atypical presentation

We report an elderly case of adult-onset Still’s disease (AOSD) with atypical presentation. The patient, an 80-year-old female, visited our hospital due to itchy linear urtical rash with low grade fever which occurred after taking a significant amount of blowfish milt four days before. Oral prednisolone of 30mg/day was successful. However, remittent fever appeared after reducing the prednisolone dose accompanied by the similar skin lesion. Hyperferritinemia was evident on the admission and the diagnosis of AOSD was made. We should keep in mind the presence of AOSD with atypical presentation in elderly patients.