Acute acalculous cholecystitis in child with systemic juvenile idiopathic arthritis, unreported manifestation.

Acute acalculous cholecystitis is a gallbladder wall inflammation without gallstones. It was not reported before as a manifestation of systemic juvenile idiopathic arthritis. Here, we describe a 13-month-old boy presented with prolonged intermittent fever, skin rash, arthritis, serositis, and hepatomegaly. After workup, he was diagnosed with systemic juvenile idiopathic arthritis and acute acalculous cholecystitis based on an ultrasound abdomen showing thick gallbladder wall with free fluid. After treatment with three days of intravenous pulse methylprednisolone, he improved dramatically, and repeated ultrasounds showed normal gallbladder. This suggests that Acute acalculous cholecystitis can be a part of systemic juvenile idiopathic arthritis and hypothesised that surgical intervention can be avoided with the use of corticosteroids.