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Unveiling Rheumatoid Arthritis: Recurrent Pericarditis as the Sentinel Manifestation.

Muhammad Majid^1,2, Ankit Agrawal¹, Aro Daniela Arockiam¹

¹Center for Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

JACC. Case Reports

|November 1, 2024

Summary

This summary is machine-generated.

Corticosteroid-resistant pericarditis in a 69-year-old man was successfully treated with anakinra, revealing rheumatoid arthritis as the cause. Anakinra effectively managed both pericarditis and rheumatoid arthritis symptoms.

Keywords:

IL-1 blockers anakinra cardiac magnetic resonance imaging recurrent pericarditis rheumatoid arthritis rilonacept transthoracic echocardiography

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Published on: February 8, 2019

Area of Science:

Rheumatology
Cardiology
Immunology

Background:

Chronic recurrent pericarditis can be challenging to manage, often requiring long-term treatment.
Idiopathic pericarditis is a common initial diagnosis, but underlying systemic causes should be investigated.
Interleukin-1 (IL-1) inhibitors are increasingly used in inflammatory conditions.

Observation:

A 69-year-old male patient presented with persistent pericarditis refractory to corticosteroids and colchicine.
Initial diagnosis of idiopathic pericarditis was considered.
Treatment was switched from anakinra to rilonacept, which led to the identification of rheumatoid arthritis as the underlying etiology.

Findings:

Anakinra demonstrated superior efficacy compared to rilonacept in managing both pericarditis and rheumatoid arthritis symptoms.
The patient's pericarditis resolved with anakinra treatment.
Rheumatoid arthritis was confirmed as the cause of the recurrent pericarditis.

Implications:

This case highlights the importance of considering systemic inflammatory diseases, such as rheumatoid arthritis, in cases of refractory pericarditis.
Anakinra may be a valuable therapeutic option for managing pericarditis associated with rheumatoid arthritis.
Early identification and targeted treatment of underlying autoimmune conditions are crucial for effective management of chronic pericarditis.