Revista Medica Herediana
ISSN 1018-130X versión impresa
A 22 year old male patient was admitted to the emergency room at the Hospital Nacional Cayetano Heredia with a history of ten days of fever, malaise and night sweats, accompanied by asthenia, mild dyspnea, and cough. His past medical history is unremarkable. Once admitted he developed acute heart failure and pericardial effusion, the analyses of the pericardial fluid and biopsy only showed no specific inflammatory changes. Antibiotic therapy was initiated by the patient progressively worsened. During the hospitalization he presented an evanescent rash and oligoarticular arthritis with culture negative and non inflammatory effusion. Because of the exclusion of infections and neoplastic disease and the clinical picture of prolonged fever with rash and oligoarticular arthritis we were concerned about the possibility of Still´s disease. We asked for serum ferritin levels which showed and extreme elevation (95 873 ng/mL). Prednisone therapy with 60mg/d was iniciated, and the fever decreased and the patient felt better. We excluded others diseases and suggested the diagnosis of Adult onset Still´s disease with myopericarditis as initial manifestation. (Rev Med Hered 2008; 19:167-170).
Palabras llave: Myopericarditis; Adult onset Still disease.
Universidad Peruana Cayetano Heredia
Facultad de Medicina "Alberto Hurtado"
Av. Honorio Delgado 430 Urb. Ingenieria, San Martin de Porres
Lima 100 - Peru