Skip to main content

Advertisement

Log in

Aseptic meningitis in adult onset Still’s disease

  • Case Report
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Adult onset Still’s disease (AOSD) is a systemic inflammatory disease characterized by high-fevers, articular involvement, maculopapular rash, hepatosplenomegaly, lymphadenopathy, and a neutrophilic leukocytosis. Though systemic complications of AOSD or its treatment are well described in the literature, CNS involvement in AOSD is exceedingly rare and can have protean manifestations. We present a patient with AOSD who developed chronic meningitis and sensorineural hearing loss on treatment, with a review of prior reported cases of aseptic meningitis, to highlight this rare complication of this uncommon illness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Bywaters EG (1971) Still’s disease in the adult. Ann Rheum Dis 30(2):121–133

    Article  PubMed  CAS  Google Scholar 

  2. Yamaguchi M et al (1992) Preliminary criteria for classification of adult Still’s disease. J Rheumatol 19(3):424–430

    PubMed  CAS  Google Scholar 

  3. Magadur-Joly G et al (1995) Epidemiology of adult Still’s disease: estimate of the incidence by a retrospective study in west France. Ann Rheum Dis 54(7):587–590

    Article  PubMed  CAS  Google Scholar 

  4. Kontzias A, Efthimiou P (2008) Adult-onset Still’s disease: pathogenesis, clinical manifestations and therapeutic advances. Drugs 68(3):319–337

    Article  PubMed  CAS  Google Scholar 

  5. Chen DY et al (2004) Predominance of Th1 cytokine in peripheral blood and pathological tissues of patients with active untreated adult onset Still’s disease. Ann Rheum Dis 63(10):1300–1306

    Article  PubMed  CAS  Google Scholar 

  6. Reginato AJ et al (1987) Adult onset Still’s disease: experience in 23 patients and literature review with emphasis on organ failure. Semin Arthritis Rheum 17(1):39–57

    Article  PubMed  CAS  Google Scholar 

  7. Hong YH, Lee CK (2008) A case of adult onset Still’s disease with systemic inflammatory response syndrome complicated by fatal status epilepticus. Rheumatol Int 28(9):931–933

    Article  PubMed  Google Scholar 

  8. Ohta A et al (1990) Adult Still’s disease: a multicenter survey of Japanese patients. J Rheumatol 17(8):1058–1063

    PubMed  CAS  Google Scholar 

  9. Tabak F et al (2003) Neutrophilic pleocytosis in cerebrospinal fluid: adult-onset Still’s disease. Intern Med 42(10):1039–1041

    Article  PubMed  Google Scholar 

  10. Gonday G et al (1981) Still’s disease in the adult (author’s transl). Sem Hop 57(45–46):1885–1889

    PubMed  CAS  Google Scholar 

  11. Lammle B, Schroder E, Steiger U (1983) Systemic chronic juvenile arthritis (Still’s disease) in adults. Review of the literature. Schweiz Med Wochenschr 113(4):126–137

    PubMed  CAS  Google Scholar 

  12. Garrote FJ et al (1993) Aseptic meningitis and focal central nervous system involvement in a case of adult onset Still’s disease. J Rheumatol 20(4):765–767

    PubMed  CAS  Google Scholar 

  13. Marie I et al (1999) Aseptic meningitis and cranial nerve palsy revealing adult-onset Still’s disease. Clin Infect Dis 29(1):220–221

    Article  PubMed  CAS  Google Scholar 

  14. Desai SS, Allen E, Deodhar A (2002) Miller Fisher syndrome in adult onset Still’s disease: case report and review of the literature of other neurological manifestations. Rheumatology (Oxford) 41(2):216–222

    Article  CAS  Google Scholar 

  15. Kanyerezi BR (1980) Still’s disease in the adults in Uganda. East Afr Med J 57(12):843–846

    PubMed  CAS  Google Scholar 

  16. Blockmans DE, Knockaert DC, Bobbaers HJ (2000) Still’s disease can cause neutrophilic meningitis. Neurology 54(5):1203–1205

    Article  PubMed  CAS  Google Scholar 

  17. Moris G, Garcia-Monco JC (1999) The challenge of drug-induced aseptic meningitis. Arch Intern Med 159(11):1185–1194

    Article  PubMed  CAS  Google Scholar 

  18. Markusse HM et al (1988) Sensorineural hearing loss in adult onset Still’s disease. Ann Rheum Dis 47(7):600–602

    Article  PubMed  CAS  Google Scholar 

  19. Denault A, Dimopoulos MA, Fitzcharles MA (1990) Meningoencephalitis and peripheral neuropathy complicating adult Still’s disease. J Rheumatol 17(5):698–700

    PubMed  CAS  Google Scholar 

  20. Sisselman SG (1999) Adult onset Still’s disease presenting as aseptic meningitis in a young healthy female. Del Med J 71(4):181–184

    PubMed  CAS  Google Scholar 

  21. Nishida T et al (2001) Hemophagocytic syndrome and adult Still’s disease associated with meningoencephalitis and unconsciousness. Intern Med 40(10):1037–1040

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest statement

The authors declare that there is no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bharath Manu Akkara Veetil.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Akkara Veetil, B.M., Yee, A.H., Warrington, K.J. et al. Aseptic meningitis in adult onset Still’s disease. Rheumatol Int 32, 4031–4034 (2012). https://doi.org/10.1007/s00296-010-1529-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-010-1529-8

Keywords

Navigation