Recurrent perimyocarditis following a non penetrating chest trauma. A case report.
A young man, after a non penetrating chest trauma, developed recurrent episodes of fever, chest pain, pleural and pericardial effusion, without laboratory evidence of viral infections, or positivity for conventional autoimmunity markers. A clearcut positivity for more specific cardiac autoantibodies, against Beta 1 adrenoceptors (AB1AA), was found (at all dilutions from 1:20 to 1:160). A full dosage of Prednisone rapidly relieved all symptoms, whereas antibiotic therapy had been previously uneffective. At a follow-up control after three months, the patient was healed and AB1AA were positive only at dilutions 1:20 and 1:40. As silent viral myocarditis was apparently ruled out by serological negativity for viral infections, it is possible that autoimmunity could have played a primary pathogenetic role for the development of pericarditis in this patient. Further work is needed to ascertain whether or not AB1AA detection could be a specific marker of cardiac autoimmunity phenomena.
De Santis
A
A
Department of Internal Medicine, Catholic University, Rome.
Fenici
R
R
Frustaci
A
A
Romito
A
A
Manna
R
R
D000328:Adult; D001323:Autoantibodies / Q000032:analysis; D001327:Autoimmune Diseases / Q000175:diagnosis*; D001706:Biopsy; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D010493:Pericarditis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D010496:Pericardium / Q000473:pathology; D011943:Receptors, Adrenergic, beta / Q000276:immunology; D013898:Thoracic Injuries / Q000150:complications*; D014949:Wounds, Nonpenetrating / Q000150:complications*
D001323:Autoantibodies; D011943:Receptors, Adrenergic, beta