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Intravenous immunoglobulin therapy for refractory recurrent pericarditis
M Rosa del Fresno1, Julio E Peralta2, Miguel Ángel Granados2
1Pediatric Rheumatology Unit and m.rosadelfresno@gmail.com.
Pediatrics
|October 8, 2014
Summary
Recurrent pericarditis after cardiac surgery can be challenging. High-dose intravenous immunoglobulin (IVIG) offers a safe and effective treatment option for refractory cases, resolving effusions in pediatric patients.
Area of Science:
- Cardiology
- Immunology
Background:
- Recurrent pericarditis, particularly postpericardiotomy syndrome in pediatric patients, poses a clinical challenge.
- Conventional treatments (NSAIDs, corticosteroids, colchicine) may be ineffective or cause adverse effects.
- Management of refractory recurrent pericarditis lacks established consensus.
Observation:
- Two pediatric patients with refractory recurrent pericarditis post-cardiac surgery were identified.
- These patients experienced persistent pericardial effusions despite conventional therapies.
Findings:
- Successful treatment was achieved using high-dose (2 g/kg) monthly intravenous immunoglobulin (IVIG).
- Treatment continued until the resolution of pericardial effusion in both patients.
- The therapy demonstrated effectiveness and a favorable safety profile.
Implications:
- High-dose IVIG represents a viable therapeutic option for pediatric patients with refractory recurrent pericarditis post-cardiac surgery.
- This approach may offer an alternative when standard treatments fail.
- Further research into IVIG's role in managing complex pericarditis is warranted.
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