[Relief of recurrent pericarditis by colchicine]

The incidence of recurrence of pericarditis is about 15-32%. The most common causes include trauma, myocardial infarction, and pericardiectomy. The optimal treatment to prevent recurrence has not been fully established. Possible modalities include nonsteroid anti-inflammatory drugs, corticosteroids, azathioprine, and pericardiectomy. We describe a 19-year-old man with osteogenic sarcoma who developed recurrent pericarditis despite treatment with prednisone and pericardiocentesis. Colchicine was administered in an effort to prevent further bouts of pericarditis. During the acute phase he was treated with a combination of prednisone, 60 mg/day, and colchicine, 1 mg/day. The dose of prednisone was then lowered to 5 mg/day. There was a recurrence when he stopped taking colchicine due to abdominal discomfort. On renewal of treatment there were no further attacks during a follow-up of 16 months. We confirm the results of a previous trial which showed that colchicine may be beneficial in preventing the recurrence of pericarditis. However, these results need corroboration by a large double-blind study.