Hemophagocytic lymphohistiocytosis is a well-known complication of adult-onset Stills disease but an unusual cause for acute liver failure. Here we present a young female with the background of fever, arthritis, rash presenting with acute onset liver failure with hepatic encephalopathy and bleeding. The diagnostic evaluation was negative for infections, autoimmune disorders or malignancies and fulfilled the criteria for adult-onset Stills disease and hemophagocytic lymphohistiocytosis resulting in acute liver failure. Treatment with liver failure regime and immunomodulation ensued a quick and complete recovery.
Key words: Adult-onset Stills disease, Acute liver failure, Hemophagocytic lymphohistiocytosis, Hepatic encephalopathy, Coagulopathy
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