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Recurrent pericarditis

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https://www.readbyqxmd.com/read/28185680/recurrent-pericarditis
#1
M Imazio, A Battaglia, L Gaido, F Gaita
Recurrent pericarditis is the most troublesome complication of pericarditis occurring in 15 to 30% of cases. The pathogenesis is often presumed to be immune-mediated although a specific rheumatologic diagnosis is commonly difficult to find. The clinical diagnosis is based on recurrent pericarditis chest pain and additional objective evidence of disease activity (e.g. pericardial rub, ECG changes, pericardial effusion, elevation of markers of inflammation, and/or imaging evidence of pericardial inflammation by CT or cardiac MR)...
February 6, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28123193/5-aminosalicylic-acid-associated-myocarditis-and-pericarditis-a-narrative-review
#2
REVIEW
Glen Brown
BACKGROUND: Use of medications containing the 5-aminosalicylic acid (5-ASA) moiety may cause a rare but potentially lethal side effect involving inflammation of the heart (myocarditis) or pericardium (pericarditis) or both (myopericarditis). Early recognition of 5-ASA as the cause is important to prevent progression of the inflammation. OBJECTIVE: To provide clinicians with information to assist in recognizing the signs and symptoms of 5-ASA-induced cardiac inflammation and the characteristics of the suspected therapy, and in determining the appropriate approach to treatment...
November 2016: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28100570/a-rare-cause-of-constrictive-pericarditis
#3
Shane Patrick Flood, Omar Ayah, Satoshi Furukawa, Robert B Norris
A 67-year-old man presented with 3 months of exertional dyspnoea and 1 week of oedema. Examination revealed elevated neck veins, pulsus paradoxus, muffled heart sounds, decreased breath sounds and pedal oedema. Transthoracic echocardiogram (TTE) demonstrated cardiac tamponade, and chest X-ray showed pleural effusion. Pericardiocentesis, thoracocentesis, laboratory investigations and CT did not elucidate an underlying aetiology. Three weeks later, he presented with recurrent cardiac tamponade and pleural effusion...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28079270/treatment-of-adults-with-idiopathic-recurrent-pericarditis-novel-use-of-immunotherapy
#4
Nicholas C Schwier, Genevieve Hale, Marie L Davies
Idiopathic recurrent pericarditis (IRP) can be challenging to treat. Even after guideline-directed, first-line treatment consisting of aspirin (ASA) or a nonsteroidal antiinflammatory drug (NSAID) in combination with colchicine therapy, recurrences still occur in greater than 20% of patients. Many patients then require treatment with long-term corticosteroids, which is not a favorable option due to their short- and long-term adverse effects. Since it is theorized that the pathophysiology of IRP may possess autoimmune sequelae, the use of immunotherapy for the treatment of IRP has emerged...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27990755/efficacy-of-anakinra-in-an-adult-patient-with-recurrent-pericarditis-and-cardiac-tamponade-as-initial-manifestations-of-tumor-necrosis-factor-receptor-associated-periodic-syndrome-due-to-the-r92q-tnfrsf1a-variant
#5
Daniel Camprubí, Francesca Mitjavila, Juan I Arostegui, Xavier Corbella
Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is a dominantly inherited autoinflammatory disease caused by TNFRSF1A mutations. Patients with TRAPS suffer from recurrent, long episodes with fever, arthralgia/arthritis, migratory myalgias, abdominal pain, serositis, conjunctivitis and migratory erythematous skin rash. More than 70 different TNFRSF1A mutations have been reported to date, and as consequence of its genetic heterogeneity, TRAPS shows a variable phenotypic expression. Among TNFRSF1A variants, the low-penetrance p...
December 19, 2016: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/27951538/colchicine-in-renal-medicine-new-virtues-of-an-ancient-friend
#6
Yalcin Solak, Dimitrie Siriopol, Abdulmecit Yildiz, Mahmut Ilker Yilmaz, Alberto Ortiz, Adrian Covic, Mehmet Kanbay
Colchicine is a plant-derived alkaloid that disrupts the cell microtubule system and accumulates in neutrophils, inhibiting neutrophil adhesion and recruitment. Colchicine has been used extensively in the prevention and treatment of gouty arthritis attacks, familial Mediterranean fever attacks and resultant AA amyloidosis, and recurrent pericarditis. Colchicine also disrupts the intracellular traffic of additional inflammatory and fibrosis mediators. Renal fibrosis is the final common pathway of chronic renal disease...
December 13, 2016: Blood Purification
https://www.readbyqxmd.com/read/27943113/significance-and-clinical-characteristics-of-atrial-fibrillation-post-epicardial-access
#7
Alan Sugrue, Ammar M Killu, David O Hodge, Christopher J McLeod, Thomas M Munger, Siva K Mulpuru, Douglas L Packer, Suraj Kapa, Samuel J Asirvatham, Paul A Friedman
INTRODUCTION: Epicardial access (EpiAcc) has become an important adjunct for ventricular tachycardia (VT) or premature ventricular complex (PVC) ablation. We hypothesized that post-procedural pericarditis may lead to an increased risk of atrial fibrillation (AF), and therefore assessed the incidence and clinical impact of post-procedural AF in patients undergoing EpiAcc. METHODS: We reviewed the records of all patients who underwent EpiAcc as part of an ablation procedure between January 1, 2004 and July 31, 2014 at Mayo Clinic Rochester...
March 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/27931089/prognostic-implications-of-epicardial-fat-volume-quantification-in-acute-pericarditis
#8
George Lazaros, Alexios S Antonopoulos, Evangelos K Oikonomou, Panagiotis Vasileiou, Evangelos Oikonomou, Evangelia Stroumpouli, Apostolos Karavidas, Charalambos Antoniades, Dimitris Tousoulis
BACKGROUND: The pathophysiology of acute pericarditis remains largely unknown, and biomarkers are needed to identify patients susceptible to complications. As adipose tissue has a pivotal role in cardiovascular disease pathogenesis, we hypothesized that quantification of epicardial fat volume (EFV) provides prognostic information in patients with acute pericarditis. MATERIALS AND METHODS: Fifty (n = 50) patients with first diagnosis of acute pericarditis were enrolled in this study...
December 8, 2016: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27894950/untying-the-gordian-knot-of-pericardial-diseases-a-pragmatic-approach
#9
REVIEW
George Lazaros, Massimo Imazio, Antonio Brucato, Dimitrios Tousoulis
Pericardial disorders constitute a relatively common cause of heart disease. Although acute pericarditis, especially the idiopathic forms that are the most prevalent, is considered a benign disease overall, its short- and long-term complications, namely, recurrent pericarditis, cardiac tamponade and constrictive pericarditis, constitute a matter of concern in the medical community. In recent years, several clinical trials contributed to redefining our traditional approach to pericardial diseases. In this review, we provide the most recent evidence concerning diagnosis, treatment modalities and short- and long-term prognosis of the most common pericardial disorders...
November 25, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27884251/complicated-pericarditis-understanding-risk-factors-and-pathophysiology-to%C3%A2-inform%C3%A2-imaging-and-treatment
#10
REVIEW
Paul C Cremer, Arnav Kumar, Apostolos Kontzias, Carmela D Tan, E Rene Rodriguez, Massimo Imazio, Allan L Klein
Most patients with acute pericarditis have a benign course and a good prognosis. However, a minority of patients develop complicated pericarditis, and the care of these patients is the focus of this review. Specifically, we address risk factors, multimodality imaging, pathophysiology, and novel treatments. The authors conclude that: 1) early high-dose corticosteroids, a lack of colchicine, and an elevated high-sensitivity C-reactive protein are associated with the development of complicated pericarditis; 2) in select cases, cardiovascular magnetic resonance imaging may aid in the assessment of pericardial inflammation and constriction; 3) given phenotypic similarities between recurrent idiopathic pericarditis and periodic fever syndromes, disorders of the inflammasome may contribute to relapsing attacks; and 4) therapies that target the inflammasome may lead to more durable remission and resolution...
November 29, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27864249/positive-predictive-value-of-cardiovascular-diagnoses-in-the-danish-national-patient-registry-a-validation-study
#11
Jens Sundbøll, Kasper Adelborg, Troels Munch, Trine Frøslev, Henrik Toft Sørensen, Hans Erik Bøtker, Morten Schmidt
OBJECTIVE: The majority of cardiovascular diagnoses in the Danish National Patient Registry (DNPR) remain to be validated despite extensive use in epidemiological research. We therefore examined the positive predictive value (PPV) of cardiovascular diagnoses in the DNPR. DESIGN: Population-based validation study. SETTING: 1 university hospital and 2 regional hospitals in the Central Denmark Region, 2010-2012. PARTICIPANTS: For each cardiovascular diagnosis, up to 100 patients from participating hospitals were randomly sampled during the study period using the DNPR...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27825009/effect-of-anakinra-on-recurrent-pericarditis-among-patients-with-colchicine-resistance-and-corticosteroid-dependence-the-airtrip-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Antonio Brucato, Massimo Imazio, Marco Gattorno, George Lazaros, Silvia Maestroni, Mara Carraro, Martina Finetti, Davide Cumetti, Alessandra Carobbio, Nicolino Ruperto, Renzo Marcolongo, Monia Lorini, Alessandro Rimini, Anna Valenti, Gian Luca Erre, Maria Pia Sormani, Riccardo Belli, Fiorenzo Gaita, Alberto Martini
Importance: Anakinra, an interleukin 1β recombinant receptor antagonist, may have potential to treat colchicine-resistant and corticosteroid-dependent recurrent pericarditis. Objective: To determine the efficacy of anakinra for colchicine-resistant and corticosteroid-dependent recurrent pericarditis. Design, Setting, and Participants: The Anakinra-Treatment of Recurrent Idiopathic Pericarditis (AIRTRIP) double-blind, placebo-controlled, randomized withdrawal trial (open label with anakinra followed by a double-blind withdrawal step with anakinra or placebo until recurrent pericarditis occurred) conducted among 21 consecutive patients enrolled at 3 Italian referral centers between June and November 2014 (end of follow-up, October 2015)...
November 8, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27762219/coxiella-burnetii-chronic-pericarditis-a-case-report
#13
I Ivić, I Božić, D Ledina
Coxiella burnetii is capable of causing a variety of acute and chronic infections. We present a case of pericarditis with serologically confirmed chronic C. burnetii infection. This case report emphasises the justification of serological testing for chronic C. burnetii infection in patients with prolonged or recurrent pericarditis, particularly in countries endemic for C. burnetii infection.
October 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27747691/hypersensitivity-eosinophilic-myocarditis-in-a-patient-receiving-multiple-drug-therapy-challenges-in-diagnosis-and-defining-the-aetiology
#14
Dario Gulin, Jozica Sikic, Jasna Cerkez Habek, Sandra Jerkovic Gulin, Edvard Galic
Eosinophilic myocarditis (EM) is a rare and potentially fatal disease if left untreated. Because the disease can have a delayed presentation and can appear even after 2 years, its underlying causes often remain unknown. We report the case of a 63-year-old man with an atypical clinical presentation of hypersensitive EM and significant coronary artery disease, which was confirmed through coronary angiography. The patient was treated with hydrochlorothiazide (12.5 mg once daily for 2 years) and budesonide/formoterol (160/4...
December 2016: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27725173/recurrent-pericarditis
#15
REVIEW
Massimo Imazio, Elena Gribaudo, Fiorenzo Gaita
Recurrent pericarditis is the most common and troublesome complication of pericarditis affecting 20% to 50% of patients. Its pathogenesis is often presumed to be immune-mediated, but additional investigations are needed to clarify the pathogenesis in order to develop etiology-oriented therapies. Imaging with computed tomography and especially cardiac magnetic resonance holds promise to help in the identification of more difficult cases and improve their management. Refractory recurrent pericarditis with corticosteroid dependence and colchicine resistance remain still an unsolved issue in search of new therapies, although old drugs such as azathioprine, intravenous immunoglobulins, and biological agents seem promising, but new randomized clinical trials are needed to confirm their role...
October 7, 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27659857/recurrent-pericarditis-as-the-presenting-form-of-adult-still-s-disease
#16
Irina Jara Calabuig, Ruth María Sánchez Soriano, Tomás Francisco Marco Domingo, Cristina Pérez Ortiz, Antonio Javier Chamorro Fernández, Carlos Israel Chamorro Fernández
No abstract text is available yet for this article.
September 19, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27631124/neisseria-meningitidis-presenting-as-acute-abdomen-and-recurrent-reactive-pericarditis
#17
Karolina Akinosoglou, Angelos Alexopoulos, Nikolaos Koutsogiannis, Charalampos Gogos, Aleksandra Lekkou
Meningococcal meningitis is a well established potential fatal infection characterized by fever, headache, petechial rash, and vomiting in the majority of cases. However, protean manifestations including abdominal pain, sore throat, diarrhea and cough, even though rare, should not be overlooked. Similarly, although disseminated infection could potentially involve various organ-targets, secondary immune related complications including joints or pericardium should be dealt with caution, since they remain unresponsive to appropriate antibiotic regimens...
November 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27580061/colchicine-for-prevention-and-treatment-of-cardiac-diseases-a-meta-analysis
#18
REVIEW
Nikolaos Papageorgiou, Alexandros Briasoulis, George Lazaros, Massimo Imazio, Dimitris Tousoulis
AIMS: Colchicine has been suggested to be beneficial in preventing recurrent pericarditis. The goal of this study was to review all randomized controlled trials that assess the use of colchicine for the prevention and treatment of cardiac diseases. METHODS: We performed a meta-analysis of the effects of colchicine on pericarditis, postpericardiotomy syndrome and postprocedural atrial fibrillation recurrence, in-stent restenosis, gastrointestinal adverse effects, and treatment discontinuation rates...
February 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/27571913/molecular-diagnosis-of-opportunistic-pericardial-infection-in-a-patient-treated-with-adalimumab-the-role-of-next-generation-sequencing
#19
Stefano Poli, Manola Comar, Roberto Luzzati, Gianfranco Sinagra
Biological immune-modulator drugs, especially inhibitors of tumor necrosis factor-α, are frequently encountered in modern clinical practice and opportunistic infections are therefore a common concern. Infective pericarditis has been described as a complication of these treatments with possible life-threatening consequences. In similar cases cultures may isolate multiple opportunistic bacteria from the pericardial fluid without specific identification of the responsible germ, representing a problem for targeted antibiotic therapy...
August 29, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27562837/natural-history-and-life-threatening-complications-in-myhre-syndrome-and-review-of-the-literature
#20
Livia Garavelli, Ilenia Maini, Federica Baccilieri, Ivan Ivanovski, Marzia Pollazzon, Simonetta Rosato, Lorenzo Iughetti, Sheila Unger, Andrea Superti-Furga, Marco Tartaglia
UNLABELLED: Myhre syndrome (OMIM 139210) is a rare developmental disorder inherited as an autosomal dominant trait and caused by a narrow spectrum of missense mutations in the SMAD4 gene. The condition features characteristic face, short stature, skeletal anomalies, muscle pseudohypertrophy, restricted joint mobility, stiff and thick skin, and variable intellectual disability. While most of the clinical features manifest during childhood, the diagnosis may be challenging during the first years of life...
October 2016: European Journal of Pediatrics
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