Acute Myopericarditis with Crohn's Disease Flare-up

Kumar, Manish; Tandon, Varun; Mosebach, Christian M; Lia, Nerea Lopetegui; Miller, W. H.

doi:10.7759/cureus.4248

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…In a noteworthy case report, the authors presented a 37-year-old male patient with an acute exacerbation of Crohn’s disease [ 75 ]. Following 2 weeks of multiple bowel movements associated with abdominal pain, which was not controlled by an increase in mesalamine and corticosteroid dose, the patient presented to the emergency department with a chief complaint of pleuritic chest pain.…”

Section: Resultsmentioning

confidence: 99%

Colchicine as a Potential Therapeutic Agent Against Cardiovascular Complications of COVID-19: an Exploratory Review

Papadopoulos

Patoulias

Teperikidis

et al. 2020

SN Compr. Clin. Med.

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Coronavirus disease-19 (COVID-19) may result in serious complications involving several organ systems, including myocardial tissue. An exaggerated host inflammatory response, described as a cytokine storm, has been linked to play a major role in these complications. Colchicine and other pharmaceutical agents have been proposed to counter the cytokine storm and improve outcomes. In this exploratory review, we utilized a PubMed and Cochrane Database search aiming to identify the biochemical characteristics of the cytokine storm as well as to identify the potential effect of colchicine on these inflammatory biomarkers. The research yielded 30 reports describing the characteristics of the cytokine storm and 44 reports describing the effect of colchicine on various inflammatory biomarkers. According to our research, colchicine may be an agent of interest in the treatment of COVID-19 via its anti-inflammatory properties. However, there are potential drug interactions with cytochrome P450 3A4 inhibitors resulting in acute colchicine toxicities. Additionally, there is scarce evidence regarding the efficacy of colchicine in the acute phase of disease, since most trials evaluated its effect in chronic conditions. In this direction, our team proposes three different hypotheses for evaluating the place of colchicine in the treatment of COVID-19.

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Section: Resultsmentioning

confidence: 99%

Colchicine as a Potential Therapeutic Agent Against Cardiovascular Complications of COVID-19: an Exploratory Review

Papadopoulos

Patoulias

Teperikidis

et al. 2020

SN Compr. Clin. Med.

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“…However, in another report, acute myopericarditis occurred 2 weeks after the intensification of therapy (prednisone and mesalazine) due to exacerbation of CD. Clinical improvement was achieved after use of colchicine with an increase in the dose of steroid [ 16 ]. Additionally, in adult patients with UC complicated by myocarditis, administration of corticosteroids led to symptoms relief [ 17 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment with Corticosteroids in an 11-Year-Old Patient with Crohn’s Disease and Myopericarditis—Case Report

et al. 2022

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Extraintestinal manifestations (EIMs) are observed in 15–20% of patients with inflammatory bowel disease (IBD). One of the rare EIMs is myocarditis, the incidence of which is estimated at around 1%. The main cause of myocarditis is a viral infection. Other causes include autoimmune diseases and drug complications (sulfasalazine, mesalazine). We present the case of an 11-year-old girl with Crohn’s disease (CD) with EIMs, manifested as hip joint inflammation and erythema nodosum. At the same time, the symptoms of myopericarditis appeared with changes in electrocardiogram (ECG), echocardiography and high troponin I concentration. Therapy with corticosteroids resulted in the resolution of skin lesions and cardiological symptoms. Systemic connective tissue diseases, viral and bacterial infections were excluded in the differential diagnosis. The suspicion of mesalazine-induced EIMs was also ruled out as the symptoms resolved despite continued therapy with mesalazine. No further recurrences of myopericarditis were observed.

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“…[16] Finally, a 2019 case of acute myopericarditis presented during a Crohn's flare-up, the treatment used was colchicine with an increase of the patient's home steroid dose, which resulted in symptomatic relief. [17] Based on current recommendations, we treated our patient with ibuprofen and colchicine.…”

Section: Discussionmentioning

confidence: 99%

“…[2] While uncommon, myopericarditis has been associated as an extra-intestinal manifestation of Crohn's disease. [3,4,5] Myopericarditis can present without acute bowel manifestations of Crohn's disease. [6] This case report was prepared following the CARE guidelines [7].…”

Section: Introductionmentioning

confidence: 99%

Myopericarditis as an Extra-Intestinal Manifestation of Crohn’s Disease: A Case Report

Prasad¹,

Chennupati²,

Kemnic³

et al. 2022

JCCI

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Introduction: Myopericarditis is an uncommon manifestation of Crohn’s disease. Interestingly enough, it can present in a patient without any acute bowel symptoms. Case Presentation: A 21-year-old male with a medical history of Crohn’s disease and eosinophilic esophagitis presented to the hospital with chest pain and fever. Blood work revealed elevated troponin, C-reactive protein, and sedimentation rate levels. Electrocardiogram (EKG) showed diffuse ST elevation in all leads. Transthoracic echocardiogram (TTE) demonstrated a small pericardial effusion without valvular abnormalities. The patient was diagnosed with myopericarditis. Extensive etiological workup was negative, in the absence of other explanations, it was attributed to his Crohn’s disease. The patient was started on colchicine and ibuprofen. Out-patient follow-up revealed resolution of symptoms. Conclusion: This case reports the rare occurrence of myopericarditis and Crohn’s disease. Inflammatory bowel disease as a cause of myopericarditis has been reported in some cases within the literature; however, there is no definitive mechanism known.

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Acute Myopericarditis with Crohn's Disease Flare-up

Cited by 6 publications

References 6 publications

Colchicine as a Potential Therapeutic Agent Against Cardiovascular Complications of COVID-19: an Exploratory Review

Colchicine as a Potential Therapeutic Agent Against Cardiovascular Complications of COVID-19: an Exploratory Review

Successful Treatment with Corticosteroids in an 11-Year-Old Patient with Crohn’s Disease and Myopericarditis—Case Report

Myopericarditis as an Extra-Intestinal Manifestation of Crohn’s Disease: A Case Report

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