{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:24:41Z","timestamp":1792758281147,"version":"4.5.0"},"reference-count":17,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,8,19]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>Adult-onset Still\u2019s disease (AOSD) is an uncommon inflammatory condition characterised by a triad of fevers, arthralgias and a salmon-coloured rash. It is also strongly associated with high ferritin levels, whose role in its pathogenesis is not entirely clear. Central nervous system (CNS) manifestations are exceedingly rare in this disease, accounting for only a handful of reported cases. Herein, we describe a case of a 63-year-old woman who developed new-onset psychiatric symptoms in the months preceding her diagnosis. 2 months after her diagnosis, she experienced an exacerbation of psychiatric symptoms followed by new-onset seizures in conjunction with an acute lung infection. In addition, we discuss two other previously reported cases of AOSD patients with psychiatric symptoms as their initial presentation.<\/jats:p>","DOI":"10.1136\/bcr-2020-235956","type":"journal-article","created":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T04:01:08Z","timestamp":1599624068000},"page":"e235956","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Neuropsychiatric manifestations in adult-onset Still\u2019s disease"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6813-1929","authenticated-orcid":false,"given":"Grant","family":"Young","sequence":"first","affiliation":[{"name":"College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1211-3793","authenticated-orcid":false,"given":"Azam S","family":"Tolla","sequence":"additional","affiliation":[{"name":"College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA"},{"name":"Hauenstein Neurosciences, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olesya","family":"Grinenko","sequence":"additional","affiliation":[{"name":"College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA"},{"name":"Hauenstein Neurosciences, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Karanec","sequence":"additional","affiliation":[{"name":"College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA"},{"name":"Hauenstein Neurosciences, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,8]]},"reference":[{"key":"2025082711321632000_13.9.e235956.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2008.08.006"},{"key":"2025082711321632000_13.9.e235956.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2018.07.018"},{"key":"2025082711321632000_13.9.e235956.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2007.01393.x"},{"key":"2025082711321632000_13.9.e235956.4","first-page":"424","article-title":"Preliminary criteria for classification of adult still's disease","volume":"19","author":"Yamaguchi","year":"1992","journal-title":"J Rheumatol"},{"key":"2025082711321632000_13.9.e235956.5","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/41.2.216"},{"key":"2025082711321632000_13.9.e235956.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-9338(12)74077-4"},{"key":"2025082711321632000_13.9.e235956.7","unstructured":"Kirk R DA . Psychiatric Manifestations of Adult-Onset Still\u2019s Disease and Treatment Considerations [abstract], in Research Day 2018 Kalamazoo. Western Michigan University Homer Stryker School of Medicine, 2018."},{"key":"2025082711321632000_13.9.e235956.8","first-page":"784","article-title":"Fulminant hepatic failure in adult onset still's disease","volume":"23","author":"Dino","year":"1996","journal-title":"J Rheumatol"},{"key":"2025082711321632000_13.9.e235956.9","article-title":"An unusual case of adult-onset still's disease with hemophagocytic syndrome, necrotic leukoencephalopathy and disseminated intravascular coagulation","volume":"2014","author":"Namas","year":"2014","journal-title":"Case Rep Rheumatol"},{"key":"2025082711321632000_13.9.e235956.10","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1097\/00007611-198005000-00005","article-title":"Acute febrile juvenile rheumatoid arthritis in adults: cause of polyarthritis and fever","volume":"73","author":"Goldman","year":"1980","journal-title":"South Med J"},{"key":"2025082711321632000_13.9.e235956.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.058"},{"key":"2025082711321632000_13.9.e235956.12","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-185"},{"key":"2025082711321632000_13.9.e235956.13","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.70.4.551"},{"key":"2025082711321632000_13.9.e235956.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.08.027."},{"key":"2025082711321632000_13.9.e235956.15","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0164"},{"key":"2025082711321632000_13.9.e235956.16","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.autrev.2015.01.007","article-title":"Seizing the clinical presentation in adult onset still's disease. 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