Methods:
Despite a normal liver biopsy in November 2023 during her third flare-up, she experienced severe hepatitis and was started on Rituximab, which was discontinued six months later due to anaphylaxis after the second dose. Currently, patient is experiencing high-grade fevers, diffuse salmon-coloured rash, icteric sclera, brown urine, and grey stools, complicating Still’s Disease, refractory to previous therapies.
Labs indicate elevated liver enzymes, indicative of acute severe hepatitis. Figure 2 depicts the patient’s latest labs, upon her 4th flare up.