Serum albumin levels (2.78 mg/dL) and platelet count (290/mm6 ) were valuable to discriminate disease flare-up and coexisting infection; moreover, high ferritin levels were accounted for adult-onset Still disease among patients with newly diagnosed rheumatic diseases.<h4>Discussion</h4>Extremely high ESR is still a valuable clinical parameter, and rheumatic causes are significant besides malignancy and infections. Here, ALB is linked to Adult onset.