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Case report
Neuropsychiatric manifestations in adult-onset Still’s disease
  1. Grant Young1,
  2. Azam S Tolla1,2,
  3. Olesya Grinenko1,2 and
  4. Kristina Karanec1,2
  1. 1College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
  2. 2Hauenstein Neurosciences, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA
  1. Correspondence to Dr Azam S Tolla; tollaaza{at}


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.

  • neurology
  • epilepsy and seizures
  • rheumatology
  • psychiatry
  • psychotic disorders (incl schizophrenia)

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  • Contributors GY: acquisition of data, drafting and revision of manuscript. AST: conception and design, drafting, and revision of manuscript. OG: interpretation of data and manuscript review. KK: acquisition of data and manuscript review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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