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Still's Disease and Myopericarditis.
Manish Kumar1, Varun Tandon2, Nerea Lopetegui Lia1
1Internal Medicine, University of Connecticut Health Center, Farmington, USA.
Cureus
|August 20, 2019
Summary
Adult-onset Still's disease (AOSD) can present with rare heart inflammation, specifically myopericarditis. Early diagnosis and treatment of this cardiac manifestation in AOSD are crucial for patient outcomes.
Area of Science:
- Rheumatology
- Cardiology
- Internal Medicine
Background:
- Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder with diverse clinical manifestations.
- Cardiopulmonary involvement in AOSD is infrequent, with myopericarditis being an exceptionally rare presentation.
Observation:
- A 44-year-old male presented with exertional chest pain, fever, and polyarthritis, suggestive of AOSD.
- Initial investigations revealed ECG abnormalities (ST elevation), elevated cardiac biomarkers (troponin, CK-MB), and markedly high ferritin levels.
- Cardiac MRI confirmed findings consistent with active myocarditis.
Findings:
- The case illustrates a rare association between Adult-onset Still's disease and myopericarditis.
- Diagnostic markers included elevated ferritin, troponin, CK-MB, and characteristic cardiac MRI findings.
- Prompt treatment with corticosteroids and NSAIDs led to significant clinical improvement.
Implications:
- This case underscores the importance of considering myopericarditis in the differential diagnosis of AOSD patients presenting with cardiac symptoms.
- Timely diagnosis and management of myopericarditis in AOSD can prevent severe cardiac complications and improve prognosis.
- Increased awareness among clinicians regarding rare cardiopulmonary manifestations of AOSD is warranted.