A Case of Refractory Adult-Onset Still Disease With Macrophage Activation Syndrome and Pulmonary Alveolar Proteinosis

Adult-onset Still disease (AOSD) is a systemic autoimmune disorder, and most patients respond well to conventional therapies, including glucocorticoids (GCs), immunosuppressants, and biologic agents. However, a small subset of patients with severe disease remains refractory to treatment and is at risk of developing life-threatening complications.