Recurrent Pericarditis: Modern Approach in 2016

摘要: Recurrent pericarditis is one of the most troublesome complications occurring in about third patients with a previous attack pericarditis. The pathogenesis presumed to be autoimmune and/or autoinflammatory cases. mainstay therapy for recurrences physical restriction and anti-inflammatory based on aspirin or NSAID plus colchicine. Corticosteroids at low moderate doses (e.g., prednisone 0.2 0.5 mg/kg/day) should considered only after failure aspirin/NSAID (and more than these drugs) specific indications pregnancy, systemic inflammatory diseases steroids, renal failure, concomitant oral anticoagulant therapy). One challenging issues how cope who have despite A small subset (about 5 %) may develop corticosteroid-dependence colchicine resistance. Among emerging treatments, three common evidence-based therapies are azathioprine, human intravenous immunoglobulin (IVIG), anakinra. After all options medical those do not tolerate serious adverse events related therapy, last possible option surgical removal pericardium. Total radical pericardiectomy recommended cases experienced centers performing this surgery. stepwise approach starting from colchicine, corticosteroid combination (NSAID, corticosteroids), then IVIG, anakinra as before pericardiectomy.