CARDIAC MANIFESTATIONS IN ADULT-ONSET STI LLS DISEASE - FROM THE PERICARDITIS TO THE ONSET PERICARDIAL TAMPONADE

Pericarditis is a common manifestation of adult still's diseases (ASD) , observed in 20% to 3% cases. Pericardial tamponade is more seldom, l ess than ten cases have been reported in the literature. We reported t wo observations of patients with ASD and pericardial tamponade above a serie of 18 patients with ASD, in one case revealed the disease. The first patient was a 32-year-old women and had fever, arthritis, high w hite blood cell count and developed pericardial tamponade. The evoluti on was favourable with bolus of methylprednisolone. In the second case , cardiac tamponade occurred several years after the onset of the dise ase. Surgical drainage was first required (800 ml) because of ineffica city of oral prednisone. A dramatic improvement was observed after bol us of methylprednisolone. In conclusion pericardial tamponade is a sel dom but sometimes the first manifestation of ASD and may required in f irst intention bolus of methylprednisolone.