{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:10:11Z","timestamp":1740179411037,"version":"3.37.3"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T00:00:00Z","timestamp":1592352000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Adult-onset Still\u2019s disease (AOSD) is an uncommon systemic inflammatory disease, causing spiking fever, skin rash, and arthritis. Pericarditis and myocarditis are the most common cardiac manifestation of AOSD but valvular involvement is rarely reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>An 18-year-old boy presented with gradually worsening shortness of breath for 6\u2009months. There was a history of low-grade intermittent fever and polyarthralgia affecting ankles, knees, and elbows. He was in heart failure with cardiogenic and septic shock. He was managed initially with antibiotics, inotropes, and diuretics. Echocardiography showed flail anterior mitral leaflet with severe mitral regurgitation. He remained febrile with persistent negative blood cultures. Intravenous antibiotics led to neutropenia without any response to fever and clinical status. On further workup, he was diagnosed to have AOSD, and he responded dramatically to oral steroid therapy. Later his mitral valve was replaced surgically. On follow-up, he was stable with mild exertional dyspnoea. His international normalized ratio\u00a0was in therapeutic range and his follow-up echocardiography showed normally functioning mitral prosthesis. He is following rheumatology and currently on the maintenance dose of steroids.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Adult-onset Still\u2019s disease is a systemic illness with diagnosis is based on clinical features and exclusion of other illnesses. Adult-onset Still\u2019s disease should be considered as a differential diagnosis in culture-negative endocarditis, especially in those with systemic features and non-responders to antibiotics.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa127","type":"journal-article","created":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T04:23:38Z","timestamp":1592367818000},"page":"1-5","source":"Crossref","is-referenced-by-count":2,"title":["A case report of Adult-onset Still\u2019s disease as a cause of severe mitral regurgitation"],"prefix":"10.1093","volume":"4","author":[{"given":"Shabir Hussain","family":"Shah","sequence":"first","affiliation":[{"name":"King Fahad Medical City, Dabab Street, Sulaimaniya, PO Box 221124, Riyadh 11311, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Azam","family":"Shah","sequence":"additional","affiliation":[{"name":"King Fahad Medical City, Dabab Street, Sulaimaniya, PO Box 221124, Riyadh 11311, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Shahbaz","family":"Khan","sequence":"additional","affiliation":[{"name":"King Fahad Medical City, Dabab Street, Sulaimaniya, PO Box 221124, Riyadh 11311, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8346-5759","authenticated-orcid":false,"given":"Faisal Abdullah","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"King Fahad Medical City, Dabab Street, Sulaimaniya, PO Box 221124, Riyadh 11311, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"key":"2020101507150402000_ytaa127-B1","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1136\/ard.2005.042143","article-title":"Diagnosis and management of adult onset Still\u2019s disease","volume":"65","author":"Efthimiou","year":"2006","journal-title":"Ann Rheum Dis [Internet]"},{"key":"2020101507150402000_ytaa127-B2","first-page":"424","article-title":"Preliminary criteria for classification of adult Still\u2019s disease","volume":"19","author":"Yamaguchi","year":"1992","journal-title":"J Rheumatol"},{"key":"2020101507150402000_ytaa127-B3","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/S0248-8663(05)81400-6","article-title":"Cardiac complications in adult onset Still disease: from pericarditis to tamponade as manifestations","volume":"15","author":"Drouot","year":"1994","journal-title":"Rev Med Interne"},{"key":"2020101507150402000_ytaa127-B4","doi-asserted-by":"crossref","first-page":"264","DOI":"10.3904\/kjim.2005.20.3.264","article-title":"Adult onset Still\u2019s disease as a cause of acute severe mitral and aortic regurgitation","volume":"20","author":"Lee","year":"2005","journal-title":"Korean J Intern Med"},{"key":"2020101507150402000_ytaa127-B5","doi-asserted-by":"crossref","first-page":"207","DOI":"10.4103\/0019-5359.53169","article-title":"Adult-onset Still\u2019s disease: a review","volume":"63","author":"Owlia","year":"2009","journal-title":"Indian J Med Sci"},{"key":"2020101507150402000_ytaa127-B6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/6502373","article-title":"Adult onset Still\u2019s disease: a review on diagnostic workup and treatment options","volume":"2016","author":"Gopalarathinam","year":"2016","journal-title":"Case Rep Rheumatol"},{"key":"2020101507150402000_ytaa127-B7","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0950-3579(05)80283-3","article-title":"Adult-onset Still\u2019s disease","volume":"5","author":"Van de Putte","year":"1991","journal-title":"Baillieres Clin Rheumatol"},{"key":"2020101507150402000_ytaa127-B8","first-page":"118","article-title":"Adult still\u2019s disease: manifestations, disease course, and outcome in 62 patients","volume":"70","author":"Pouchot","year":"1991","journal-title":"Medicine (United States)"},{"key":"2020101507150402000_ytaa127-B9","first-page":"665","article-title":"Adult Still\u2019s disease\u2014recognition of a clinical syndrome and recent experience","volume":"142","author":"Larson","year":"1985","journal-title":"West J Med"},{"key":"2020101507150402000_ytaa127-B10","first-page":"1055","article-title":"Adult-onset Still\u2019s disease; 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