Transient constrictive pericarditis in Bruton disease: a case report

Abstract

Introduction. Constrictive pericarditis is a long-term consequence of any pathological process developing in the pericardium due to fibrinous thickening and calcification of its layers, which prevents normal cardiac diastolic filling. One of its forms is transient constrictive pericarditis, which resolves after anti-inflammatory therapy.Brief description. A 19-year-old man with Bruton disease was admitted to the clinic with complaints of severe weakness, shortness of breath at rest, cough, chest pain, hyperthermia to 380 C, decreased blood pressure to 80/60 mm Hg, and abdominal distension. During the initial echocardiography, the results did not raise serious suspicions. However, given the rather specific interventricular septum motion, pericardial constriction was suspected.Discussion. During the additional examination, echocardiography made it possible to verify constrictive pericarditis, which was subsequently confirmed by heart catheterization. Due to significant immunoglobulin level deviations, a decision was made to resume immunoglobulin replacement therapy, followed by a clinical status reassessment.The article presents a clinical description of a patient with constrictive pericarditis, which was a manifestation of Bruton disease. During follow-up, resolution of constriction was noted with resumption of immunoglobulin replacement therapy.