Hemorrhagic pericardial effusion in beta-thalassemia major: report of a case.
Although sterile pericardial effusion occurs in about half of the patients with massive iron overload, hemorrhagic pericardial effusion is rarely seen in beta-thalassemia major patients. A 10-year-old girl with beta-thalassemia major who was diagnosed in her early infancy developed a massive hemorrhagic pericardial effusion. She was receiving blood transfusions every 4-6 weeks without chelating therapy with an average hemoglobin (Hb) level of 6-9 g/dL. Progressive hepatospenomegaly was noted during the course. She had complained of orthopnea with palpitation and bilateral leg edema before admission. After evaluation, a massive pericardial effusion was found and pericardiocentesis was performed twice, which revealed a bloody and uncoagulable effusion. Finally a pericardial window was performed to eliminate the bloody effusion. Negative etiological evaluations of blood and pericardial effusion were reported. Pathological examination of the pericardial biopsy revealed hemosiderosis with a few lymphocytic infiltrates. We report this case for its rarity and its necessity for urgent treatment.
Chou
Y H
YH
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, Taipei, R.O.C.
Chen
R L
RL
Lin
K H
KH
Lin
D T
DT
Huang
P H
PH
D002648:Child; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D010490:Pericardial Effusion / Q000209:etiology*; D013789:Thalassemia / Q000150:complications*