Adult Still's Disease Complicated by Cardiac Tamponade

Abstract

To the Editor.— I was delighted to read Dr Jamieson's report of adult Still's disease complicated by cardiac tamponade for both personal and scientific reasons. Still's disease had been my earliest interest 2 and pericardial disease has been a continuing interest. 3 In the usual (juvenile) Still's disease, pericarditis with effusions and pericardial adhesions have long been known. 1 I believe that Dr Jamieson is correct in considering tamponade rare. (Perhaps intercurrent viral or other pericarditis may have been the cause or a precipitant in some cases.) Examining Fig 2 of this excellent report, I note what appears to be a large left pleural effusion, probably larger than any right pleural effusion; would the author care to comment on this? This is consistent with our recent report of the remarkable prevalence of left pleural effusions in patients with both effusive and dry pericardial disease. 4