Adult Still's disease and Tako-Tsubo syndrome

Here we describe the case of a 68-year-old Italian female who was admitted in our hospital for the occurrence of arthralgia, abdominal pain and general discomfort. The clinical picture was complicated by recurrent febrile episodes up to 40 degrees C associated with skin rush and cardiorespiratory failure with ECG ischemic alteration, TnT-hs troponin elevation and an ipoakinetic alteration of the apex at the echocardiogram examination. After an intensive workup, the diagnosis of an adult Still's disease was formulated according to the classification criteria. Moreover, the patient underwent coronarographic study and cardiac MR that, collectively, supported the diagnosis of Tako-Tsubo syndrome. The patient was treated with steroid obtaining the remission of the disease. Myocardial injury with adult Still's disease was been rarely reported. In our case we observed for the first time, to our knowledge, a case of adult Still's disease complicated by a Tako-Tsubo syndrome.