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Recurrent pericarditis in children: elevated cardiac autoantibodies.
R Dalla Pozza1, D Hartl, S Bechtold
1Department of Pediatric Cardiology, University Children's Hospital, Lindwurmstr. 4, 80337, Munich, Germany. Robert.DallaPozza@med.uni-muenchen.de
Summary
Antimyolemmal antibodies (AMLAs) were detected in children with recurrent pericarditis. Persistent IgM-type AMLAs may indicate frequent recurrences, suggesting an autoimmune link.
Area of Science:
- Pediatric Cardiology
- Immunology
- Rheumatology
Background:
- Recurrent pericarditis in children is challenging due to treatment resistance.
- Etiology is often unclear, lacking predictors for recurrence frequency or severity.
Observation:
- Antimyolemmal antibodies (AMLAs) were detected in four pediatric patients with recurrent pericarditis.
- Three patients showed prolonged IgM-type AMLAs, with one experiencing 48 recurrences over 5.5 years.
- One patient had a rapid IgM to IgG AMLA conversion, experiencing fewer recurrences.
Findings:
- Detection of AMLAs in pediatric recurrent pericarditis suggests a potential autoimmune etiology.
- Persistent IgM-type AMLAs correlate with more frequent and severe recurrences.
- AMLA type and persistence may serve as biomarkers for disease activity.
Implications:
- Propose AMLA detection for children with unexplained recurrent pericarditis.
- Suggest closer monitoring for pediatric patients with persistent IgM-type AMLAs.
- Recommend adjusted anti-inflammatory treatment strategies, including slower tapering, for these patients.
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