Hepatitis A infection mimicking adult onset Still's disease

Fever, rash, and arthritis may be components of the prodrome of viral hepat itis. In the absence of jaundice and abnormal liver function tests, this fo rm of polyarthritis is easily confused with primary autoimmune diseases. Wh ereas the association of systemic illness with musculoskeletal symptoms and numerous viral infections is well known, such an association with hepatiti s A has only been rarely reported. We describe a case of hepatitis A infect ion mimicking adult onset Still's disease, and review the pathogenesis and differential diagnosis of Still's disease and the extraarticular manifestat ions of hepatitis.