Cardiac tamponade in Still disease: a review of the literature.

Adult onset Still disease is an unusual multisystem inflammatory disorder of unknown etiology and pathogenesis. Among its protean manifestations is pericarditis which occurs in approximately 30-40% of patients. Cardiac tamponade is a rare complication of pericarditis occurring in the context of Still disease. We conducted a review of the English literature pertaining to the occurrence of pericardial tamponade in Still disease. We searched relevant journals and the PubMed Medline databases. A total of eighteen reported cases were identified; ten among children and eight in adults. Treatment of pericardial tamponade was medical therapy alone in two cases versus combined modality, medical and surgical drainage in the remainder of the cases. Outcomes were death among four of the ten children and there was no recurrence of tamponade in the remaining child and adult series. This review re-emphasizes the importance of considering Still disease in the differential diagnosis of the life-threatening emergency of pericardial tamponade.