Immunosuppressive therapy prevents recurrent pericarditis

Marcolongo, R; Russo, R; Laveder, Francesco; Noventa, Franco; Agostini, Carlo

doi:10.1016/0735-1097(95)00302-9

Cited by 76 publications

(46 citation statements)

References 15 publications

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“…Melchior and colleagues 22 successfully interrupted the relapses in two patients given a pulse therapy of corticosteroids, in which 1 g of methylprednisolone was given on three consecutive days. Similarly, Marcolongo and colleagues 23 reported a series of 12 patients with recurrent pericarditis, all of whom had been given corticosteroids at low dose without success. A three months course of treatment with prednisone at immunosuppressive dosage was started (1-1.5 mg/kg body weight per day for four weeks, followed by gradual withdrawal).…”

Section: High Dose Steroidal Treatmentmentioning

confidence: 93%

Relapsing pericarditis

Soler‐Soler

2004

Heart

145

133

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Section: High Dose Steroidal Treatmentmentioning

confidence: 93%

Relapsing pericarditis

Soler‐Soler

2004

Heart

145

133

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“…[44][45][46] Corticosteroids and immunosuppressive agents may be used in refractory cases. [47][48][49] Relapses may occur during reduction of drug doses or after discontinuation of treatment. These may arise due to insufficient dose or/and duration of NSAIDs, too rapid tapering of corticosteroids, real reactivation in autoimmune forms, or true reinfection.…”

Section: Irap Therapymentioning

confidence: 99%

“…48 In refractory cases, eg, those requiring unacceptably high chronic dosages of corticosteroids (higher than 15-20 mg/day) for symptom control, several immunosuppressive or immunomodulatory drugs have been employed, in particular azathioprine, cyclosporine, methotrexate, hydroxychloroquine, high dose intravenous immunoglobulins, and cyclophosphamide. 47,49 Azathioprine (at a dosage of 2-3 mg/kg/day) has been most often used. In general, less toxic and less expensive drugs are preferred, tailoring therapy to the individual patient as well as to the physician's preference.…”

Section: Irap Therapymentioning

confidence: 99%

See 1 more Smart Citation

Acute idiopathic pericarditis: current immunological theories

Caforio¹,

Marcolongo²,

Brucato³

et al. 2012

RRCC

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Idiopathic recurrent acute pericarditis (IRAP) is a rare disease of suspected immune-mediated pathogenesis. It represents a diagnosis of exclusion. It is necessary to rule out infectious and noninfectious causes of pericardial inflammation, including systemic autoimmune and immune-related disorders, eg, Sjögren's disease, systemic lupus erythematosus. Since pericarditis may precede diagnosis of these disorders, IRAP diagnosis is often made after a long follow-up. According to the two main pathogenetic theories IRAP may represent an organ-specific autoimmune disease or an autoinflammatory disease (AInfD). The main evidence for autoimmunity in IRAP is provided by the detection of serum antiheart and antiintercalateddisk autoantibodies, and the response to anti-inflammatory or immunosuppressive therapy. The findings of familial forms and of proinflammatory cytokines in the pericardial fluid in IRAP would be in keeping with both organ-specific autoimmune disease and AInfD. In fact, AInfD are genetic disorders characterized by primary dysfunction of the innate immune system, due to mutations of genes involved in the regulation of the inflammatory response, in the absence of antigen specific T cells or autoantibodies. In AInfD there are active disease phases with raised non-cardiac specific inflammatory markers, such as C-reactive protein, as well as symptom-free intervals with possible C-reactive protein normalization. A minority of IRAP patients (6%) carry a mutation in the TNFRSF1A gene, encoding the receptor for tumor necrosis factor-alfa. This suggests that some IRAP patients may have an atypical or subclinical form of AInfD. Thus, IRAP may represent a syndrome with distinct pathogenetic mechanisms in different patients' subsets.

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“…Only 1 retrospective study supports their use. 10 Following this study, reviews and current European guidelines on the management of pericardial diseases 3,[5][6][7][8] have recommended the use of high doses of prednisone (1.0 to 1.5 mg · kg Ϫ1 · d Ϫ1 ) for 1 month in patients with recurrent pericarditis when corticosteroids are considered.…”

mentioning

confidence: 99%

Corticosteroids for Recurrent Pericarditis

et al. 2008

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Background-Corticosteroid use is widespread in recurrent pericarditis, even if rarely indicated, and high doses (eg, prednisone 1.0 to 1.5 mg · kg Ϫ1 · d Ϫ1 ) are generally recommended, although only weak evidence supports their use with possible severe side effects. The aim of this work was to compare side effects, recurrences and other complications, and hospitalizations of a low-versus high-dose regimen of prednisone for recurrent pericarditis. Methods and Results-A retrospective review of all cases of recurrent pericarditis treated with corticosteroids according to different regimens from January 1996 to June 2004 was performed in 2 Italian referral centers. One hundred patients with recurrent pericarditis (mean age, 50.1Ϯ15.8 years; 57 females) were included in the study; 49 patients (mean age, 47.5Ϯ16.0; 25 females) were treated with low doses of prednisone (0.2 to 0.5 mg · kg Ϫ1 · d

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Immunosuppressive therapy prevents recurrent pericarditis

Cited by 76 publications

References 15 publications

Relapsing pericarditis

Relapsing pericarditis

Acute idiopathic pericarditis: current immunological theories

Corticosteroids for Recurrent Pericarditis

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