Electroconvulsive Therapy as a Potential Trigger of Adult Onset StillÃ¢ÂÂs Disease
- *Corresponding Author:
- Conrad Rauber
Department of Gastroenterology and Hepatology
Division of Rheumatology, University Hospital Heidelberg
Tel: +49 6221 560
E-mail: [email protected]
Received Date: April 24, 2017; Accepted Date: May 15, 2017; Published Date: May 20, 2017
Citation: Rauber C, Ruping FM, Blank N, Merle U (2017) Electroconvulsive Therapy as a Potential Trigger of Adult Onset Still’s Disease. J Clin Case Rep 7:958. doi: 10.4172/2165-7920.1000958
Copyright: © 2017 Rauber C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Adult onset Still’s disease (AOSD) is an inflammatory disorder of unknown etiology. Macrophage activation syndrome (MAS) is a complication of AOSD and may present with multiorgan failure including cerebral involvement.
Clinical presentation: We describe a 43-year-old female patient with major depression treated with electroconvulsive therapy (ECT). She presented with febrile pharyngitis, arthralgia, rashes, lymphadenopathy, hepatosplenomegaly, liver failure and aseptic meningitis. Elevated serum ferritin and negative blood cultures were consistent with the diagnosis of AOSD complicated by MAS. The patient was treated with corticosteroids and anakinra and recovered rapidly.
Conclusion: The case highlights aseptic meningitis, depression and multiorgan failure as a feature of AOSD/ MAS possibly triggered by ECT. Anakinra is an effective treatment in severe MAS.