Adult-onset Still's disease revealed by perimyocarditis and a concomitant reactivation of an EBV infection

BMJ Case Rep. 2012 Nov 19:2012:bcr0120113688. doi: 10.1136/bcr.01.2011.3688.

Abstract

We describe a 17-year-old patient presenting perimyocarditis as the initial manifestation of the adult-onset Still's disease. Corticotherapy was rapidly successful but induced major acute hepatitis in relation with Epstein-Barr virus reactivation. After 1 year, even if the global outcome is favourable, a slightly lowered ejection fraction still persists. Former case reports and differential diagnosis with reactive haemophagocytic syndrome would be discussed.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Diagnosis, Differential
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Echocardiography
  • Epstein-Barr Virus Infections / diagnosis*
  • Heart Ventricles / pathology
  • Humans
  • Lymphohistiocytosis, Hemophagocytic / diagnosis
  • Magnetic Resonance Imaging
  • Male
  • Myocarditis / diagnosis*
  • Myocardium / pathology
  • Pericarditis / diagnosis*
  • Prednisone / adverse effects
  • Prednisone / therapeutic use
  • Still's Disease, Adult-Onset / diagnosis*
  • Still's Disease, Adult-Onset / drug therapy
  • Virus Activation*

Substances

  • Anti-Inflammatory Agents
  • Prednisone