Seizing the clinical presentation in adult onset Still's disease. An extensive literature review

•Adult-onset Still's disease (AOSD) is a rare inflammatory disorder.•Clinical presentation ranges from self-limiting to multiple rare manifestations.•Glycosylated ferritin is a more specific diagnostic marker than ferritin.•NSAIDS are first line treatment for mild to moderate disease.•Pulse methylprednisolone for life threatening disease

Adult onset Still's disease is an inflammatory disorder with a wide clinical presentation ranging from arthralgia and arthritis to rash and high-grade fever. Etiology of this rare disorder remains a mystery. We present two cases at the extreme ends of clinical presentation diagnosed with AOSD along with literature review for the same. Case one was self limiting, requiring only NSAIDS as treatment. The other was an unusual central nervous system manifestation of repeated seizures that were only responsive to pulse dose of methylprednisolone. Both met Yamaguchi criteria for adult onset Still's disease.