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Case Report
April 15, 1983

Adult Still's Disease Complicated by Cardiac Tamponade

Author Affiliations


From the Department of Internal Medicine, Naval Regional Medical Center, Portsmouth, Va. Dr Jamieson is now a fellow in the Division of Allergy, Clinical Immunology, and Rheumatology, University of Kansas Medical Center, Kansas City.

JAMA. 1983;249(15):2065-2066. doi:10.1001/jama.1983.03330390069036

SYSTEMIC-onset juvenile rheumatoid arthritis in the adult (adult Still's disease) is a clinical diagnosis. It is not a diagnosis made with the aid of serological studies, but rather can only be made by a suspecting clinician as he constructs a patient's composite clinical profile. A sufficient awareness of the disease's features is needed to avoid unnecessary diagnostic procedures and delay in commenceing therapy.1 This case report examines the panorama of clinical features that can be seen in adult Still's disease and reports a rare complication: pericardial effusion with cardiac tamponade.

Report of a Case  A 21-year-old man was admitted to a hospital in Panama in July 1981 with a two-week history of sore throat, fever, chills, myalgias, arthralgias (hips, shoulders, metacarpal phalangeal joints, proximal interphalangeal joints, and right knee), and weight loss. There was no history of drug intake (medical or nonmedical) before the onset of symptoms. The patient