The adult-onset Still disease is a rare systemic inflammatory disease characterized by high fever, evanescent eruption, polyarthritis and leukocytosis. Pregnancy is not a risk factor for this disease. The authors report a case which started on the pregnancy's thirtieth week, with high fever, polyarthritis, cutaneous eruption, myalgia, headache, subcutaneous nodules in lower limbs and cervical lymphadenopathy. It evolved to accentuated oligohydramnios and alteration of the fetus-placenta and fetal cerebral flow. A Caesarean section was performed. The newborn had a 7/8 Apgar score, weighted 1,500 g and was admitted to an intensive care unit presenting breathing discomfort, icterus, exanthema and necrotizing enterocolitis, among other complications which led to his death after 41 days in the intensive care unit. The patient presented clinical and laboratorial symptoms suggesting adult-onset Still disease although other feverish pathologies were investigated as differential diagnosis. There was a satisfactory evolution with use of indomethacin, prednisone and methotrexate and the patient is currently in remission, using only methotrexate. The patient has presented a definite diagnosis for adult-onset Still disease according to the criteria proposed for the disease. The newborn's death was a consequence of prematurity and infectious risk, factors which could have been minimized had the mother's condition been precociously diagnosed.
Still disease; Still disease in pregnancy; newborn death
