DISSEMINATED INTRAVASCULAR COAGULATION IN STILLS DISEASE

Still's disease is characterized by arthritis, fever, rash, lymphoid h ypertrophy, leukocytosis, and anemia, often in association with thromb ocytosis. We describe a patient with Still's disease and thrombocytope nia secondary to disseminated intravascular coagulation (DIC). Fifteen definite cases of DIC complicating Still's disease have been reported in the English literature. Most developed this complication while rec eiving high doses of salicylates in association with hepatic dysfuncti on. In a few, the coagulopathy has been associated with gold therapy. Our patient is only the second reported to develop DIC in the absence of drug therapy and the fourth reported to die from this complication. The clinical features of these 16 patients are summarized and propose d mechanisms of pathogenesis are reviewed.