Recurrent pericarditis in children and adolescents

Abstract

The most frequent background for RP in children was the closure of ASD after the age of six years. Its course was unpredictable and often chronic, irrespective of the underlying cause or the therapy given. Colchicine did not prevent relapses.

2015 ESC Guidelines for the diagnosis and management of pericardial diseases

“…Wpływ wieku i płci na choroby osierdzia jest obecnie bardziej wyraźny i jasny, co odzwierciedlają szczegółowe zalecenia dotyczące postępowania u pacjentek w ciąży [17][18][19][20][21][22][23][24][25][26][27].…”

“…Kryteria rozpoznania i ryzyko nawrotów jest również podobne (15-30%). Wśród czynników etiologicznych wymienia się, oprócz schorzeń takich jak u dorosłych, nieco częstsze występowanie PPS, szczególnie po zabiegach korekty ubytku w przegrodzie międzyprzed-sionkowej [18]. W porównaniu z dorosłymi u dzieci częściej występują wydatne cechy zapalenia, z gorączką, zajęciem opłucnej i płuc oraz zwiększeniem stężenia CRP, natomiast rzadziej wykrywa się przeciwciała przeciwjądrowe (ANA).…”

Anesthesia and the patient with pericardial disease

“…Steroids may also be added as secondary therapy, but in studies that have used glucocorticoids as first-line therapy, the incidence of recurrence appears to be greater, [52][53][54] making routine steroids inadvisable. 55,56 The exception is in patients with connective tissue disorders or severe recurrent pericarditis where high-dose steroids may be primarily indicated. 57 …”

Intravenous Immunoglobulin Therapy for Refractory Recurrent Pericarditis

“…1,2 In children, almost 50% of the cases occur after cardiac surgery. 3 RP is a condition that is difficult to manage and often results in the frustration of patients, families, and treating physicians. The guideline on pericardial syndrome by the European Society of Cardiology, updated in 2012, 4 recommends nonsteroidal antiinflammatory drugs with additional colchicine as the first line of therapy, with the use of low-dose steroids for those who do not respond.…”

“…It is not uncommon, however, for patients to become steroid-dependent or to continue to have pericardial effusion. In such cases, several therapies have been successfully used, including immunosuppressive agents such as azathioprine or methotrexate, [2][3][4][5] interleukin (IL)-1 receptor antagonist, [6][7][8][9][10] anti-tumor necrosis factor (anti-TNF) drugs, 11 and intravenous immunoglobulin (IVIG). [12][13][14][15] Herein, we report on 2 children with refractory postpericardiotomy syndrome who were successfully treated with IVIG.…”