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Inflamed Colon and Pericardium: A Rare Combination of Colitis and Recurrent Pericarditis
Ashwin K Kumar1, Muhammad M Furqan1, Abdullah Yesilyaprak1
1Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
JACC. Case Reports
|August 17, 2021
Summary
Severe ulcerative colitis complicated a young woman's recurrent pericarditis. Anti-inflammatory therapy improved inflammation, but relapses occurred on biologics, suggesting alternative treatments like rilonacept may be needed.
Area of Science:
- Cardiology
- Gastroenterology
- Rheumatology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Pericarditis, inflammation of the pericardium, can be a rare complication of UC.
- Recurrent pericarditis poses significant management challenges.
Observation:
- A 29-year-old woman with severe UC experienced complicated recurrent pericarditis.
- Cardiac MRI demonstrated reduced pericardial inflammation after extended anti-inflammatory treatment.
- Despite therapy, the patient suffered multiple relapses, including while on biologic agents.
Findings:
- Prolonged anti-inflammatory therapy provided initial improvement in pericardial inflammation.
- Biologic therapies for UC did not prevent recurrent pericarditis in this case.
- The patient's condition remained refractory to standard treatments.
Implications:
- For refractory recurrent pericarditis in severe UC, novel therapies should be considered.
- Rilonacept, an interleukin-1 antagonist, presents a potential therapeutic option.
- Disease-modifying antirheumatic drugs and pericardiectomy are alternative considerations for complex cases.
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