Adult-onset Still’s disease during pregnancy: two case reports and a comprehensive literature review

Background: Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder marked by recurrent fever, rash, arthritis, and multi-organ involvement. Its occurrence with pregnancy complicates diagnosis and management. Objectives: To present the diagnosis and treatment process of two pregnant patients with newly diagnosed AOSD. Cases: Two cases of AOSD were initially diagnosed during pregnancy. Case one involved a pregnant woman at 16 + 2 weeks of gestation with recurrent fevers, rash, and myalgia. She responded well to treatment with methylprednisolone and cyclosporine and subsequently had a normal vaginal delivery. Case two involved a pregnant woman at 30 + 6 weeks of gestation who presented with systemic joint pain and fever. After being diagnosed with AOSD, she underwent a cesarean section. Treatment included methylprednisolone, cyclosporine, and addition of methotrexate postpartum. Conclusion: Adult-onset Still's disease can be triggered by pregnancy, requiring a multidisciplinary approach for optimal management and fetal outcomes.