Case Report
Acute Miopericarditis as the Presenting Feature of Adult-Onset Still's Disease
Miopericarditis aguda como presentación de enfermedad de Still del adulto
Read
9357
Timeswas read the article
2564
Total PDF
6793
Total HTML
Share statistics
array:24 [ "pii" => "S2173574311000487" "issn" => "21735743" "doi" => "10.1016/j.reumae.2011.03.002" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "320" "copyright" => "Elsevier España, S.L.. All rights reserved" "copyrightAnyo" => "2010" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2012;8:31-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3600 "formatos" => array:3 [ "EPUB" => 53 "HTML" => 2865 "PDF" => 682 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1699258X1100132X" "issn" => "1699258X" "doi" => "10.1016/j.reuma.2011.03.002" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "320" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2012;8:31-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 12528 "formatos" => array:3 [ "EPUB" => 163 "HTML" => 10627 "PDF" => 1738 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso clínico</span>" "titulo" => "Miopericarditis aguda como presentación de enfermedad de Still del adulto" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "31" "paginaFinal" => "33" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Acute miopericarditis as the presenting feature of adult-onset Still's disease" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2630 "Ancho" => 2917 "Tamanyo" => 1070284 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudios de apoyo paraclínico que evidenciaron la presencia de miopericarditis: taquicardia sinusal y ondas T negativas en derivaciones V4-V6 del ECG (A), cardiomegalia global y derrame pleural bilateral en la radiografía de tórax (B), derrame pleuropericárdico y cardiomegalia en la TC toraco-abdominal (C), derrame pericárdico leve a moderado en el ecocardiograma (D).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Gema García-García, Verónica Fernández-Auzmendi, Fermín Olgado-Ferrero, Dolores Magro-Ledesma, Sara Sánchez Giralt" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Gema" "apellidos" => "García-García" ] 1 => array:2 [ "nombre" => "Verónica" "apellidos" => "Fernández-Auzmendi" ] 2 => array:2 [ "nombre" => "Fermín" "apellidos" => "Olgado-Ferrero" ] 3 => array:2 [ "nombre" => "Dolores" "apellidos" => "Magro-Ledesma" ] 4 => array:2 [ "nombre" => "Sara" "apellidos" => "Sánchez Giralt" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574311000487" "doi" => "10.1016/j.reumae.2011.03.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574311000487?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X1100132X?idApp=UINPBA00004M" "url" => "/1699258X/0000000800000001/v1_201305061912/S1699258X1100132X/v1_201305061912/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173574311000463" "issn" => "21735743" "doi" => "10.1016/j.reumae.2011.01.002" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "314" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2012;8:34-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 6043 "formatos" => array:3 [ "EPUB" => 51 "HTML" => 5310 "PDF" => 682 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Trochanteric Bursitis Due to Tuberculosis in an Immunocompetent Young Woman" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "34" "paginaFinal" => "35" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Bursitis trocantérea tuberculosa en mujer joven inmunocompetente" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 810 "Ancho" => 950 "Tamanyo" => 81070 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Bilobar collection around the left large trochanter measuring 6<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>cm, with heterogeneous content.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sandra Soro Marín, Maria Asunción Sánchez Trenado, María Dolores Mínguez Sánchez, Marcos Paulino Huertas, Paula Virginia García Morales, Verónica Salas Manzanedo" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Sandra" "apellidos" => "Soro Marín" ] 1 => array:2 [ "nombre" => "Maria Asunción" "apellidos" => "Sánchez Trenado" ] 2 => array:2 [ "nombre" => "María Dolores" "apellidos" => "Mínguez Sánchez" ] 3 => array:2 [ "nombre" => "Marcos Paulino" "apellidos" => "Huertas" ] 4 => array:2 [ "nombre" => "Paula Virginia" "apellidos" => "García Morales" ] 5 => array:2 [ "nombre" => "Verónica" "apellidos" => "Salas Manzanedo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X11000787" "doi" => "10.1016/j.reuma.2011.01.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X11000787?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574311000463?idApp=UINPBA00004M" "url" => "/21735743/0000000800000001/v1_201305061634/S2173574311000463/v1_201305061634/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173574312000044" "issn" => "21735743" "doi" => "10.1016/j.reumae.2011.10.003" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "380" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Reumatol Clin. 2012;8:27-30" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2609 "formatos" => array:3 [ "EPUB" => 59 "HTML" => 2041 "PDF" => 509 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special Article</span>" "titulo" => "What Do Rheumatology Residents Think of Their Training? A Survey of the National Rheumatology Commission" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "27" "paginaFinal" => "30" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Qué opinan los residentes de reumatología sobre su formación? Una encuesta de la Comisión Nacional de Reumatología" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Luis Andreu, Marta García Castro, Jacqueline Usón, Juan Ángel Jover, Isabel Millán, Rafael Cáliz, Javier De Toro, Federico Díaz, Nuria Guañabens, Alejandro Olivé, Sigrid Talaverano, Elisa Trujillo" "autores" => array:12 [ 0 => array:2 [ "nombre" => "José Luis" "apellidos" => "Andreu" ] 1 => array:2 [ "nombre" => "Marta" "apellidos" => "García Castro" ] 2 => array:2 [ "nombre" => "Jacqueline" "apellidos" => "Usón" ] 3 => array:2 [ "nombre" => "Juan Ángel" "apellidos" => "Jover" ] 4 => array:2 [ "nombre" => "Isabel" "apellidos" => "Millán" ] 5 => array:2 [ "nombre" => "Rafael" "apellidos" => "Cáliz" ] 6 => array:2 [ "nombre" => "Javier" "apellidos" => "De Toro" ] 7 => array:2 [ "nombre" => "Federico" "apellidos" => "Díaz" ] 8 => array:2 [ "nombre" => "Nuria" "apellidos" => "Guañabens" ] 9 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Olivé" ] 10 => array:2 [ "nombre" => "Sigrid" "apellidos" => "Talaverano" ] 11 => array:2 [ "nombre" => "Elisa" "apellidos" => "Trujillo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X11003172" "doi" => "10.1016/j.reuma.2011.10.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X11003172?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574312000044?idApp=UINPBA00004M" "url" => "/21735743/0000000800000001/v1_201305061634/S2173574312000044/v1_201305061634/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Acute Miopericarditis as the Presenting Feature of Adult-Onset Still's Disease" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "31" "paginaFinal" => "33" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Gema García-García, Verónica Fernández-Auzmendi, Fermín Olgado-Ferrero, Dolores Magro-Ledesma, Sara Sánchez Giralt" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Gema" "apellidos" => "García-García" "email" => array:1 [ 0 => "geminway21@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Verónica" "apellidos" => "Fernández-Auzmendi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Fermín" "apellidos" => "Olgado-Ferrero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Dolores" "apellidos" => "Magro-Ledesma" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Sara" "apellidos" => "Sánchez Giralt" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Complejo Hospitalario Universitario Infanta Cristina, Badajoz, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital de Don Benito-Villanueva (Badajoz), Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Cardiología, Complejo Hospitalario Universitario Infanta Cristina, Badajoz, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Miopericarditis aguda como presentación de enfermedad de Still del adulto" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2630 "Ancho" => 2917 "Tamanyo" => 1070284 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Studies that showed the presence of myopericarditis: sinus tachycardia and negative T waves in V4–V6 ECG (A), global cardiomegaly and bilateral pleural effusion on chest X-ray (B), pleuropericardial effusion and cardiomegaly on thoraco-abdominal CT (C), mild to moderate pericardial effusion on echocardiography (D).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Adult Still's disease (ASD) is more common in young adults. We report the case of a man 20 years with cardiac manifestations as initial presentation.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Case Report</span><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 20 year old male, without past medical history who was admitted because of 3 weeks with fever, joint pain in the spine, shoulders and wrists, right rib pleuritic pain, dyspnea and orthopnea. The examination revealed cutaneous-mucous pallor, tachypnea, jugular venous distention, latero-cervical lymphadenopathy, systolic murmur, pericardial friction rub, bibasal hypophonesis, hepatosplenomegaly and bilateral malleoli edema.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Laboratory tests revealed hemoglobin 9.3<span class="elsevierStyleHsp" style=""></span>g/dl, WBC 33<span class="elsevierStyleHsp" style=""></span>200/mm<span class="elsevierStyleSup">3</span> (93.8% neutrophils), platelets 512<span class="elsevierStyleHsp" style=""></span>000/mm<span class="elsevierStyleSup">3</span>, prothrombin activity 51.9%, AST 177<span class="elsevierStyleHsp" style=""></span>U/l, ALT 108<span class="elsevierStyleHsp" style=""></span>U/l, gamma-glutamyl transpeptidase 225<span class="elsevierStyleHsp" style=""></span>U/l, LDH 1044<span class="elsevierStyleHsp" style=""></span>U/l and troponin I 3<span class="elsevierStyleHsp" style=""></span>ng/ml. C-reactive protein was 262.8<span class="elsevierStyleHsp" style=""></span>mg/l, ESR 97<span class="elsevierStyleHsp" style=""></span>mm/h and ferritin 37<span class="elsevierStyleHsp" style=""></span>640<span class="elsevierStyleHsp" style=""></span>ng/ml. Thyroid hormones, immunoglobulins and complement were normal. Rheumatoid factor, ANA, extractable nuclear antigen, anti-nDNA, antineutrophil cytoplasmic and antiphospholipid antibodies were negative. Serology, blood cultures, urine cultures and Mantoux testing was negative. A blood smear showed no abnormalities. Arterial blood gas showed partial respiratory failure. Electrocardiogram revealed sinus tachycardia with negative T in V4–6 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). A chest radiography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B) showed global cardiomegaly and bilateral pleural effusion. Exudative pleural fluid, with smears, cultures and cytology were negative. The horaco-abdominal CT (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C) revealed minimum pleuropericardial effusion, cardiomegaly and hepatomegaly. The echocardiogram (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D) revealed mild-moderate pericardial effusion, an ejection fraction of 41% of the left ventricle, moderate-severe mitral regurgitation and mild to moderate mitral stenosis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The presence of pericardial chest pain, physical examination characteristics and elevated cardiac enzymes were consistent with myopericarditis. Treatment was initiated with NSAIDs and broad-spectrum antibiotics to cover infectious etiology. Given the presentation with fever, arthritis, liver dysfunction, leukocytosis, pleural and organ enlargement, ASD was diagnosed by the criteria proposed by Yamaguchi and intravenous bolus of corticosteroids started, followed by oral prednisone in a descending pattern. Progressive improvement was shown in clinical, biochemical, radiological (normal) and echocardiography (mild pericardial effusion and grade II mitral insufficiency with Valsalva) parameters. Later, coinciding with the decline of prednisone dosage, an outbreak similar to the initial one occurred, which improved with an increase of prednisone, leading to the addition of methotrexate, which helped to stabilize the disease and lower the dose of prednisone.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">Fever is the most common clinical manifestation of ASD, followed by arthritis of the knees and wrists.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Our patient has not presented an evanescent rash with fever that is typical and frequent. Up to 30–40% of cases have serosal involvement.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–7</span></a> Pericarditis is the most common cardiac manifestation and is usually subclinical in up to 50%. Myocarditis is rare and can cause arrhythmias. Other, exceptional manifestations are cardiac tamponade, constrictive pericarditis or endocarditis. Hepatic dysfunction is common with cytolysis pattern, usually mild to moderate, and in our patient was associated with impaired coagulation.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The characteristic elevation of acute phase reactant ferritin, considered a marker of active disease and response to treatment, does not occur in other rheumatic diseases.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The diagnosis<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> is clinical, with Yamaguchi's criteria being the most used; 5 criteria are required, with at least 2 in adults:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0040" class="elsevierStylePara elsevierViewall">Main criteria: fever of at least 39<span class="elsevierStyleHsp" style=""></span>°C over 7 days, joint pain or arthritis of more than 2 weeks, rash, and leukocytosis (≥10<span class="elsevierStyleHsp" style=""></span>000/mm<span class="elsevierStyleSup">3</span>) with at least 80% neutrophils.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0045" class="elsevierStylePara elsevierViewall">Minor criteria: sore throat, lymphadenopathy, hepato/splenomegaly, liver dysfunction (primarily AST, ALT and LDH), negative ANA and rheumatoid factor. It is necessary to exclude infections, lymphoproliferative or granulomatous disease.</p></li></ul></p><p id="par0050" class="elsevierStylePara elsevierViewall">At the start of treatment,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> oral or intravenous steroids are used if the situation is serious. Subsequently, immunosuppressants, mainly methotrexate, may be associated to control the disease and reduce the dose of corticosteroids. If no response is seen, biological therapies may be administered.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusions</span><p id="par0055" class="elsevierStylePara elsevierViewall">ASD is a multisystemic inflammatory disease of unknown etiology. Its initial presentation with pleural and myopericardial manifestations is uncommon.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:2 [ "identificador" => "xres125655" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec112949" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres125656" "titulo" => "Resumen" ] 3 => array:2 [ "identificador" => "xpalclavsec112948" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case Report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusions" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-12-29" "fechaAceptado" => "2011-03-08" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec112949" "palabras" => array:3 [ 0 => "Still's disease" 1 => "Myopericarditis" 2 => "Immunosuppressants" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec112948" "palabras" => array:3 [ 0 => "Enfermedad de Still" 1 => "Miopericarditis" 2 => "Inmunosupresores" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Adult Still's disease (ASD) was described by George Still in 1896. ASD is a rare inflammatory disorder, of unknown etiology, whose clinical manifestations are manifold. Diagnosis requires high clinical suspicion and exclusion of different etiologies. We report the case of a 20 year old male with fever, arthritis, dyspnea and chest pain. Laboratory findings showed increased levels of cardiac enzymes, and a pleuropericardic effusion was detected in imaging tests, both of them showing myopericarditis. Corticosteroid treatment was started with initial improvement, although the addition of methotrexate was necessary in the following months.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La enfermedad del Still del adulto (ESA) fue descrita en niños por George Still en 1896. La ESA es una entidad inflamatoria, infrecuente, de etiología desconocida cuyas manifestaciones clínicas son múltiples. El diagnóstico requiere una alta sospecha clínica y la exclusión de diferentes etiologías. Presentamos el caso de un varón de 20 años que consultó por fiebre, artritis, disnea y dolor costal. Se objetivaron elevación de enzimas cardiacas, y en las pruebas de imagen, derrame pleuropericárdico compatibles con miopericarditis. Se inició tratamiento con corticoides con mejoría inicial, precisando en los meses posteriores la adición de metotrexato.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please, cite this article as: García-García G, et al. Miopericarditis aguda como presentación de enfermedad de Still del adulto. Reumatol Clin. 2012;<span class="elsevierStyleBold">8(1)</span>:31–33.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2630 "Ancho" => 2917 "Tamanyo" => 1070284 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Studies that showed the presence of myopericarditis: sinus tachycardia and negative T waves in V4–V6 ECG (A), global cardiomegaly and bilateral pleural effusion on chest X-ray (B), pleuropericardial effusion and cardiomegaly on thoraco-abdominal CT (C), mild to moderate pericardial effusion on echocardiography (D).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Mandl LA, Esdaile JM. Clinical manifestations and diagnosis of adult Still's disease. In: Basow DS, editor. UpToDate on line. Waltham; May 2010." ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Polyserositis in adult Still's disease with onset during pregnancy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Falkenbach" 1 => "B. Lembcke" 2 => "M. Schneider" 3 => "R. Wigand" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Rheumatol" "fecha" => "1994" "volumen" => "13" "paginaInicial" => "513" "paginaFinal" => "517" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7755716" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atypical presentation of adult Still's disease mimicking acute bacterial endocarditis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Zenagui" 1 => "J.P. De Coninck" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "1995" "volumen" => "16" "paginaInicial" => "1448" "paginaFinal" => "1450" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8746917" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Myopericarditis revealing adult-onset Still's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Vandergheynst" 1 => "J. Gosset" 2 => "P. Van de Borne" 3 => "G. Decaux" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1179/acb.2005.037" "Revista" => array:7 [ "tituloSerie" => "Acta Clin Belg" "fecha" => "2005" "volumen" => "60" "paginaInicial" => "205" "paginaFinal" => "208" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16279403" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S014067360209894X" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of severe adult-onset Still's disease presenting with pleuropericarditis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Ikeue" 1 => "A. Fukuhara" 2 => "S. Watanabe" 3 => "T. Sugita" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nihon Kokyuki Gakkai Zasshi" "fecha" => "2006" "volumen" => "44" "paginaInicial" => "389" "paginaFinal" => "393" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16780097" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adult-onset Still's disease revealed by a pericardial tamponade: report of two cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I. Ben Ghorbel" 1 => "M. Lamloum" 2 => "M. Miled" 3 => "N. Aoun" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Med Intern" "fecha" => "2006" "volumen" => "27" "paginaInicial" => "546" "paginaFinal" => "549" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rare case of reversible constrictive pericarditis with severe pericardial thickening in a patient with adult onset Still's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.J. Buss" 1 => "D. Wolf" 2 => "D. Mereles" 3 => "N. Blank" 4 => "H.A. Katus" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2008.12.079" "Revista" => array:6 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2010" "volumen" => "144" "paginaInicial" => "e23" "paginaFinal" => "e25" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19185937" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enfermedad de Still del adulto y valor diagnóstico de la ferritina sérica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Chanqueo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Reumatología" "fecha" => "2001" "volumen" => "17" "paginaInicial" => "179" "paginaFinal" => "183" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adult-onset Still disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B. Fautrel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.berh.2008.08.006" "Revista" => array:6 [ "tituloSerie" => "Best Pract Res Clin Rheumatol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "773" "paginaFinal" => "792" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19028363" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Mandl LA, Esdaile JM. Treatment of adult Still's disease. In: Basow DS, editor. Uptodate on line. Waltham; May 2010." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000000800000001/v1_201305061634/S2173574311000487/v1_201305061634/en/main.assets" "Apartado" => array:4 [ "identificador" => "17376" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Case Report" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000000800000001/v1_201305061634/S2173574311000487/v1_201305061634/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574311000487?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 15 | 19 | 34 |
| 2024 October | 76 | 39 | 115 |
| 2024 September | 62 | 28 | 90 |
| 2024 August | 83 | 36 | 119 |
| 2024 July | 64 | 39 | 103 |
| 2024 June | 66 | 36 | 102 |
| 2024 May | 54 | 40 | 94 |
| 2024 April | 55 | 27 | 82 |
| 2024 March | 61 | 35 | 96 |
| 2024 February | 50 | 30 | 80 |
| 2024 January | 40 | 28 | 68 |
| 2023 December | 43 | 34 | 77 |
| 2023 November | 55 | 35 | 90 |
| 2023 October | 48 | 35 | 83 |
| 2023 September | 70 | 33 | 103 |
| 2023 August | 45 | 28 | 73 |
| 2023 July | 35 | 29 | 64 |
| 2023 June | 36 | 27 | 63 |
| 2023 May | 39 | 23 | 62 |
| 2023 April | 48 | 17 | 65 |
| 2023 March | 89 | 28 | 117 |
| 2023 February | 79 | 32 | 111 |
| 2023 January | 46 | 21 | 67 |
| 2022 December | 74 | 34 | 108 |
| 2022 November | 69 | 38 | 107 |
| 2022 October | 85 | 40 | 125 |
| 2022 September | 58 | 24 | 82 |
| 2022 August | 51 | 44 | 95 |
| 2022 July | 63 | 36 | 99 |
| 2022 June | 45 | 39 | 84 |
| 2022 May | 75 | 42 | 117 |
| 2022 April | 70 | 50 | 120 |
| 2022 March | 94 | 58 | 152 |
| 2022 February | 129 | 49 | 178 |
| 2022 January | 127 | 34 | 161 |
| 2021 December | 73 | 30 | 103 |
| 2021 November | 69 | 42 | 111 |
| 2021 October | 104 | 53 | 157 |
| 2021 September | 97 | 41 | 138 |
| 2021 August | 70 | 39 | 109 |
| 2021 July | 77 | 44 | 121 |
| 2021 June | 88 | 50 | 138 |
| 2021 May | 87 | 41 | 128 |
| 2021 April | 213 | 106 | 319 |
| 2021 March | 119 | 35 | 154 |
| 2021 February | 58 | 23 | 81 |
| 2021 January | 53 | 17 | 70 |
| 2020 December | 61 | 20 | 81 |
| 2020 November | 131 | 19 | 150 |
| 2020 October | 93 | 13 | 106 |
| 2020 September | 73 | 19 | 92 |
| 2020 August | 54 | 20 | 74 |
| 2020 July | 27 | 33 | 60 |
| 2020 June | 51 | 15 | 66 |
| 2020 May | 53 | 15 | 68 |
| 2020 April | 56 | 14 | 70 |
| 2020 March | 21 | 6 | 27 |
| 2020 February | 2 | 0 | 2 |
| 2019 January | 1 | 0 | 1 |
| 2018 November | 1 | 0 | 1 |
| 2018 May | 4 | 1 | 5 |
| 2018 April | 72 | 10 | 82 |
| 2018 March | 58 | 13 | 71 |
| 2018 February | 39 | 6 | 45 |
| 2018 January | 44 | 5 | 49 |
| 2017 December | 58 | 8 | 66 |
| 2017 November | 40 | 8 | 48 |
| 2017 October | 32 | 4 | 36 |
| 2017 September | 53 | 8 | 61 |
| 2017 August | 66 | 7 | 73 |
| 2017 July | 76 | 13 | 89 |
| 2017 June | 94 | 9 | 103 |
| 2017 May | 87 | 7 | 94 |
| 2017 April | 62 | 10 | 72 |
| 2017 March | 64 | 18 | 82 |
| 2017 February | 54 | 6 | 60 |
| 2017 January | 42 | 7 | 49 |
| 2016 December | 71 | 17 | 88 |
| 2016 November | 58 | 7 | 65 |
| 2016 October | 84 | 15 | 99 |
| 2016 September | 77 | 8 | 85 |
| 2016 August | 73 | 11 | 84 |
| 2016 July | 42 | 7 | 49 |
| 2016 June | 0 | 11 | 11 |
| 2016 May | 0 | 5 | 5 |
| 2016 April | 0 | 6 | 6 |
| 2016 March | 2 | 8 | 10 |
| 2015 December | 2 | 0 | 2 |
| 2015 September | 4 | 0 | 4 |
| 2015 August | 2 | 11 | 13 |
| 2015 July | 15 | 8 | 23 |
| 2015 June | 53 | 13 | 66 |
| 2015 May | 53 | 14 | 67 |
| 2015 April | 50 | 10 | 60 |
| 2015 March | 50 | 19 | 69 |
| 2015 February | 44 | 13 | 57 |
| 2015 January | 47 | 10 | 57 |
| 2014 December | 63 | 13 | 76 |
| 2014 November | 38 | 17 | 55 |
| 2014 October | 58 | 13 | 71 |
| 2014 September | 42 | 12 | 54 |
| 2014 August | 40 | 20 | 60 |
| 2014 July | 50 | 14 | 64 |
| 2014 June | 51 | 12 | 63 |
| 2014 May | 39 | 17 | 56 |
| 2014 April | 36 | 13 | 49 |
| 2014 March | 41 | 17 | 58 |
| 2014 February | 34 | 14 | 48 |
| 2014 January | 37 | 10 | 47 |
| 2013 December | 52 | 13 | 65 |
| 2013 November | 51 | 14 | 65 |
| 2013 October | 50 | 9 | 59 |
| 2013 September | 41 | 11 | 52 |
| 2013 August | 37 | 16 | 53 |
| 2013 July | 36 | 5 | 41 |
| 2013 June | 42 | 10 | 52 |
| 2013 May | 40 | 17 | 57 |
| 2013 April | 41 | 14 | 55 |
| 2013 March | 37 | 12 | 49 |
| 2013 February | 29 | 8 | 37 |
| 2013 January | 36 | 16 | 52 |
| 2012 December | 34 | 10 | 44 |
| 2012 November | 28 | 9 | 37 |
| 2012 October | 23 | 9 | 32 |
| 2012 September | 23 | 4 | 27 |
| 2012 July | 8 | 0 | 8 |
| 2012 June | 11 | 0 | 11 |
| 2012 May | 10 | 0 | 10 |
| 2012 April | 11 | 0 | 11 |
| 2012 March | 12 | 0 | 12 |
| 2012 February | 9 | 0 | 9 |
Show all
