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BMJ Case Rep ; 13(9)2020 Sep 08.
Article in English | MEDLINE | ID: mdl-32907867

ABSTRACT

Adult-onset Still's disease (AOSD) is an uncommon inflammatory condition characterised by a triad of fevers, arthralgias and a salmon-coloured rash. It is also strongly associated with high ferritin levels, whose role in its pathogenesis is not entirely clear. Central nervous system (CNS) manifestations are exceedingly rare in this disease, accounting for only a handful of reported cases. Herein, we describe a case of a 63-year-old woman who developed new-onset psychiatric symptoms in the months preceding her diagnosis. 2 months after her diagnosis, she experienced an exacerbation of psychiatric symptoms followed by new-onset seizures in conjunction with an acute lung infection. In addition, we discuss two other previously reported cases of AOSD patients with psychiatric symptoms as their initial presentation.


Subject(s)
Aggression , Mania/immunology , Paranoid Behavior/immunology , Seizures/immunology , Still's Disease, Adult-Onset/diagnosis , Anticonvulsants/administration & dosage , Arthralgia/immunology , Diagnosis, Differential , Electroencephalography , Female , Fever/immunology , Glucocorticoids/therapeutic use , Humans , Levetiracetam/administration & dosage , Lorazepam/administration & dosage , Mania/diagnosis , Mania/drug therapy , Methotrexate/therapeutic use , Middle Aged , Paranoid Behavior/diagnosis , Paranoid Behavior/drug therapy , Seizures/drug therapy , Still's Disease, Adult-Onset/complications , Still's Disease, Adult-Onset/drug therapy , Still's Disease, Adult-Onset/immunology , Treatment Outcome
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