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Colchicine for recurrent pericarditis in children
1Department of Paediatrics, St. George Hospital, Beirut, Lebanon.
Insights
Colchicine effectively treats recurrent pericarditis in children unresponsive to other therapies. This approach shows promising long-term results with no adverse reactions, offering a new treatment option for pediatric cases.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Rheumatology
Background:
- Recurrent acute pericarditis affects 15-30% of children, leading to significant morbidity.
- Current treatments like NSAIDs and corticosteroids have variable success and side effects.
- Colchicine has shown promise in adult recurrent pericarditis, but pediatric data is lacking.
Observation:
- Three children with recurrent pericarditis, refractory to NSAIDs/corticosteroids, were treated with colchicine.
- Treatment duration was 6 months.
- No adverse reactions were reported during colchicine therapy.
Findings:
- All three children demonstrated remarkable improvement with colchicine treatment.
- Patients remained well 11-18 months after discontinuing colchicine.
- This suggests colchicine is a safe and effective option for pediatric recurrent pericarditis.
Implications:
- Colchicine offers a novel, well-tolerated therapeutic option for pediatric recurrent pericarditis.
- This study supports further investigation into colchicine's role in managing pediatric inflammatory cardiac conditions.
- Findings may reduce long-term morbidity associated with recurrent pericarditis in children.
Abstract:
The incidence of recurrence of acute pericarditis in children varies from 15% to 30% and is accompanied by a high morbidity. Various treatment modalities have been used with variable success rates and side effects. La Serna et al. (Lancet 1987; 26: 1517) were the first to treat adults with recurrent pericarditis with colchicine, and were followed by other authors. To our knowledge no studies in children have been reported. In this paper, we present three children who suffered from viral or idiopathic recurrent pericarditis, despite multiple courses of non-steroidal anti-inflammatory drugs (NSAIDs) and/or corticosteroids. They responded remarkably well to colchicine, which was administered for 6 months with no adverse reactions. They continue to do well 18, 11 and 12 months after cessation of treatment, respectively.