Viral pericarditis in patients receiving hemodialysis

Area of Science:

• Nephrology
• Infectious Diseases
• Cardiology

Background:

• End-stage renal disease (ESRD) patients on intermittent hemodialysis are susceptible to pericarditis.
• The etiology of pericarditis in these patients is often attributed to uremia.
• Viral infections are a potential, yet under-recognized, cause of pericarditis in dialysis patients.

Observation:

• Four patients with ESRD on hemodialysis presented with pericarditis.
• Evaluations focused on identifying potential viral triggers for the pericarditis.
• Clinical course included cardiac tamponade in three patients, necessitating surgical intervention in two.

Findings:

• Elevated or rising serum antibody titers indicated recent infection with influenza virus A in three patients.
• One patient showed evidence of coxsackievirus B infection.
• All patients with viral pericarditis achieved full recovery after treatment.

Implications:

• Viral pericarditis is a significant and potentially treatable cause of pericarditis in patients with end-stage renal disease undergoing chronic hemodialysis.
• Distinguishing viral pericarditis from uremic pericarditis is crucial for appropriate management and improved patient outcomes.
• This finding may necessitate broader infectious disease screening in dialysis-associated pericarditis cases.