An Unusual Association of Adult-Onset Still’s Disease, Aseptic Meningitis, and Concurrent Celiac Disease in a Young Patient

Adult-onset Still's disease (AOSD) is a rare systemic autoinflammatory disorder that presents a diagnostic challenge for many clinicians because of its heterogeneous clinical manifestations and overlap with infectious and other inflammatory conditions.In contrast, celiac disease is a common immune-mediated disorder triggered by gluten ingestion, which damages the small intestine and prevents proper nutrient absorption.It affects only a small proportion of the global population.We present the case of a 24-year-old woman who was initially hospitalized with abdominal pain, high-grade fever, and sore throat, accompanied by leukocytosis and abnormal liver function tests, and later developed altered mental status.An extensive rheumatologic evaluation was negative; however, serologic testing for celiac disease was positive, and the diagnosis was subsequently confirmed by esophagogastroduodenoscopy with duodenal biopsy.The patient also met the Yamaguchi criteria for AOSD with concomitant aseptic meningitis presentation.AOSDassociated aseptic meningitis is uncommon, and its coexistence with newly diagnosed celiac disease has not been reported in the literature.This case highlights the importance of considering AOSD in patients presenting with aseptic meningitis and systemic inflammatory features, particularly when an infectious etiology is not identified.Early recognition and prompt initiation of appropriate therapy are essential for better clinical outcomes.