MYOCARDITE AIGUE REVELANT UNE MALADIE DE STILL

Adult Still disease is an uncommon disorder usually associating high spiking fever, evanescent skin rash constituted of small salmon pink macules, and arthritis. It is characterized by numerous systemic manifestations; a sore throat is common, mobile and indolent lymph nodes, usually in the cervical area. Liver involvement is common and usually limited to a mild or moderate cytolysis. Amongst the other numerous systemic manifestations that have been reported, pericarditis is common, rarely a myocarditis, the pulmonary involvement may lead to an acute respiratory distress, and the rare neurological manifestations include aseptic meningitis or cranial nerve palsy. From a biological point of view the sedimentation rate is consistently elevated and there is usually a marked elevation in the polymorphonuclears. The bacteriological survey is negative as are the immunological tests. It is the increase of the serum level of ferritin and the marked decrease in its glycosylated fraction below 20% that seem to be of more potent diagnostic value. We report an uncommon case of a 28-year-old patient admitted for myocarditis whose etiological investigations revealed an adult Still disease.