[Constrictive pericarditis in severe seronegative rheumatoid polyarthritis].
Constrictive pericarditis is a rare complication of rheumatoid arthritis, with 78 published cases. We report a new typical case where the pericardial disease was associated with a severe seronegative rheumatoid arthritis of 17 years duration. Constrictive pericarditis generally occurs in men (62.8% of all cases) aged 52.4 +/- 11.5 years. Its clinical features are identical with those of constrictive pericarditis due to other causes. Diagnosis rests on echocardiography and, chiefly, on right heart catheterization. The arthritis is seropositive in 85.7% of the cases, frequently nodular (75%) and advanced. There is no relation between its duration (mean: 9.6 +/- 7.4 years) and the occurrence of the pericardial pathology. The pericardial fluid has no specific abnormality. Histology shows fibrosis and a non-specific inflammatory cell infiltrate. Immunoglobulin and complement deposits in the walls of the pericardial vessels are detected by immunofluorescence. The only treatment is pericardiectomy; without it the disease is constantly lethal.
Bologna
C
C
Service de Rhumatologie, Hôpital Lapeyronie, CHU, Montpellier.
Poirier
J L
JL
Hérisson
C
C
Simon
L
L
D000974:Antibodies, Antinuclear / Q000032:analysis; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000276:immunology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000209:etiology* / Q000276:immunology / Q000601:surgery
D000974:Antibodies, Antinuclear
Péricardite constrictive au cours d'une polyarthrite rhumatoïde sévère séro-négative.