title: [Myopericarditis as the presenting manifestation of adult Still's disease].
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service de médecine interne et polyvalente, centre hospitalier de Polynésie française, Tahiti, 98713 Pirae, Polynésie française. Electronic address: erwan.oehler@cht.pf.
authors.forename: E
authors.initials: E
authors.lastname: Oehler
authors.affiliation: Service de médecine interne et polyvalente, centre hospitalier de Polynésie française, Tahiti, 98713 Pirae, Polynésie française.
authors.forename: F
authors.initials: F
authors.lastname: Valour
authors.affiliation: Service de médecine interne, hôpital Claude-Hurriez, 59037 Lille cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Hachulla
authors.affiliation: Service de neurologie, centre hospitalier de Polynésie française, Tahiti, 98713 Pirae, Polynésie française.
authors.forename: F
authors.initials: F
authors.lastname: Ghawche
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000209:etiology*; D010493:Pericarditis / Q000209:etiology*; D016706:Still's Disease, Adult-Onset / Q000175:diagnosis*
keywords: Adults Still's disease; Maladie de Still de l’adulte; Myocardite; Myocarditis