Amyloidosis in Still's disease.

Still (1897) first described the form of chronic polyarthritis of childhood now associated with his name, and six years later Whitman (1903) described two such cases complicated by amyloidosis, but since then few cases with peost-mortemn findings have been reported. Portis (1938) gave the findings in two fatal cases of Still's disease with amyloidosis, and was able to find five further cases among twelve post-mortem accounts in the literature. Trasoff and others (1944), in a review of the literature, collected 31 cases of amyloidosis in rheumatoid arthritis (nine below 16 years of age), all but five of which are known to have died. They also described a case of a patient suffering from Still's disease with amyloidosis who recovered, and they quote a similar case from Kennedy (1935). Further cases of this combination of diseases are recorded from the Massachusetts General Hospital (1945), by Coss and Boots (1946), and by Pickard (1947). Dahlin (1949) has recently given an account of the pathology of amyloidosis. Amyloid disease complicating rheumatoid arthritis and Still's disease is of secondary type (Reimann and others, 1935) affecting mainly the kidneys, liver and spleen. The case presented below is one of Still's disease of severe nature, with gross pericarditis and complicated by amyloidosis.