Clinical management and therapy of idiopathic recurrent pericarditis

Clinical management and therapy of idiopathic recurrent pericarditis

Authors

  • Andrea Assolari Internal Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
  • Silvia Maestroni Internal Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
  • Davide Cumetti Internal Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
  • Anna Valenti Internal Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
  • Federico Parisi Internal Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
  • Antonio Brucato Internal Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy

DOI:

https://doi.org/10.7175/cmi.v12i1.1339

Keywords:

Recurrence, Pericarditis, Anti-Inflammatory Agents, Non-Steroidal, Immunotherapy, Interleukin 1 Receptor Antagonist Protein

Abstract

Recurrent pericarditis is defined when pericarditic chest pain reappears after a symptom-free period of at least 4 to 6 weeks and after completion of full-dose anti-inflammatory therapy. Idiopathic pericarditis is the commonest etiology. The diagnosis of idiopathic cases is essentially an exclusion diagnosis, supported by a typical clinical course. The diagnosis is based on the association of typical symptoms and signs: mainly pericarditic chest pain plus pericardial rubs or electrocardiographic alterations or pericardial effusion. The optimal regimen for recurrences includes combination of non-steroidal anti-inflammatory agents, colchicine, and corticosteroids. In the resistant forms, immunotherapy (azathioprine, intravenous immunoglobulins, and particularly anakinra) has shown to be effective. The long term outcome of idiopathic recurrent pericarditis is good, with no evolution towards constrictive form.

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Published

2019-01-16

Issue

Vol. 12 No. 1 (2018)

Section

Clinical management

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