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

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 fav...

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Veröffentlicht in:	BMJ case reports 2012-11, Vol.2012 (nov16 1), p.bcr0120113688-bcr0120113688
Hauptverfasser:	Meckenstock, Roderich, Therby, Audrey, Gibault-Genty, Geraldine, Khau, David, Monnier, Sebastien, Greder-Belan, Alix
Format:	Artikel
Sprache:	eng
Schlagworte:	Adolescent Anti-Inflammatory Agents - adverse effects Anti-Inflammatory Agents - therapeutic use Arthritis Chemical and Drug Induced Liver Injury - diagnosis Diagnosis, Differential Disease Dose-Response Relationship, Drug Drug Administration Schedule Echocardiography Ejection fraction Epstein-Barr virus Epstein-Barr Virus Infections - diagnosis Europe (West) Fever Heart Heart Ventricles - pathology Hepatitis Humans Lymphohistiocytosis, Hemophagocytic - diagnosis Magnetic Resonance Imaging Male Myocarditis Myocarditis - diagnosis Myocardium - pathology Pericarditis Pericarditis - diagnosis Prednisone - adverse effects Prednisone - therapeutic use Skin Still's Disease, Adult-Onset - diagnosis Still's Disease, Adult-Onset - drug therapy Unusual Presentation of More Common Disease/Injury Virus Activation White
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Beschreibung
Zusammenfassung:	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.
ISSN:	1757-790X 1757-790X
DOI:	10.1136/bcr.01.2011.3688