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Rev Med Interne. 2014 Dec;35(12):827-30. doi: 10.1016/j.revmed.2013.06.014. Epub 2013 Dec 2.

[Myopericarditis as the presenting manifestation of adult Still's disease].

[Article in French]

Author information

1
Service de médecine interne et polyvalente, centre hospitalier de Polynésie française, Tahiti, 98713 Pirae, Polynésie française. Electronic address: erwan.oehler@cht.pf.
2
Service de médecine interne et polyvalente, centre hospitalier de Polynésie française, Tahiti, 98713 Pirae, Polynésie française.
3
Service de médecine interne, hôpital Claude-Hurriez, 59037 Lille cedex, France.
4
Service de neurologie, centre hospitalier de Polynésie française, Tahiti, 98713 Pirae, Polynésie française.

Abstract

INTRODUCTION:

Adult Still's disease may present with multiple non-specific clinical manifestations leading to diagnostic difficulties. Presentation as initial myopericarditis is rare but must be known.

CASE REPORT:

We report a 49-year-old man who presented with the sudden onset of a high fever, arthralgia and myalgia, skin rash, dyspnea and chest pain related to a myopericarditis. Infectious, neoplastic and autoimmune diagnostic work-up was non-contributive. Adult Still's disease was discussed and confirmed by the decrease in the glycosylated fraction of ferritin. Corticosteroids followed by interleukin-1 receptor antagonist (anakinra) therapy allowed a rapid improvement in clinical and biological manifestations.

CONCLUSION:

Adult Still's disease should be considered in any systemic inflammatory disease without a diagnosis, even with atypical manifestations, especially since it can be life-threatening in the absence of treatment.

KEYWORDS:

Adults Still's disease; Maladie de Still de l’adulte; Myocardite; Myocarditis

PMID:
24309545
DOI:
10.1016/j.revmed.2013.06.014
[Indexed for MEDLINE]
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