Ben Ghorbel I, Lamloum M, Miled M, Aoun Naji, Houman M-H, Pouchot Jacques
Service de Médecine Interne, Hôpital La-Rabta, 1007 Tunis, Tunisie.
Rev Med Interne. 2006 Jul;27(7):546-9. doi: 10.1016/j.revmed.2006.03.027. Epub 2006 Apr 7.
Adult onset Still's disease is a systemic inflammatory disorder of unknown etiology characterized by the association of a high spiking fever, an evanescent skin rash, arthritis, and hyperleukocytosis. Pericarditis is amongst the most common systemic manifestations of adult onset Still's disease.
We report on two patients with a pericardial tamponade revealing an adult onset Still's disease in a 52-year-old female and a 31-year-old male. Pericardial fluid was bloody in the two cases, and histopathology only disclosed non specific inflammatory changes. Both patients received corticosteroids and outcome was uneventful with a follow-up of 8 years and 12 months, respectively.
Pericardial tamponade is an uncommon clinical feature of adult-onset Still's disease and usually occurs at disease onset. It makes the diagnosis of adult-onset Still's disease difficult as the other disease manifestations are commonly neglected. Adult onset Still's disease should be added to the differential of acute pericarditis and tamponade.
成人斯蒂尔病是一种病因不明的全身性炎症性疾病，其特征为高热、一过性皮疹、关节炎和白细胞增多。心包炎是成人斯蒂尔病最常见的全身表现之一。
我们报告了两例心包填塞病例，分别为一名52岁女性和一名31岁男性，均确诊为成人斯蒂尔病。两例心包积液均为血性，组织病理学仅显示非特异性炎症改变。两名患者均接受了皮质类固醇治疗，随访8年和12个月后，结果均良好。
心包填塞是成人斯蒂尔病的一种罕见临床特征，通常发生在疾病发作时。由于其他疾病表现常被忽视，这使得成人斯蒂尔病的诊断变得困难。成人斯蒂尔病应列入急性心包炎和心包填塞的鉴别诊断范围。
