ADULT STILLS-DISEASE WITH MYOCARDIAL DYSFUNCTION INDUCED BY MICROANGIOPATHY

A 52-year-old man with inflammatory disease of unknown origin but no s pecific laboratory abnormalities was referred to our hospital. He was subsequently diagnosed as having adult Still's disease. During an epis ode of severe inflammation he suffered reversible myocardial damage as revealed by electrocardiography, echocardiography and (TI)-T-201 myoc ardial scintigraphy; this was ameliorated by treatment with steroids a nd immunosuppressive drugs. No significant stenosis of the coronary ar tery was observed on coronary angiography. Interstitial mononuclear in filtration was apparent in the right ventricle on endomyocardial biops y. Myocardial injury with adult Still's disease, which may result in h eart failure, has rarely been reported. We report a case of adult Stil l's disease with myocardial dysfunction that may have been caused by m icroangiopathy.