[Pericardial effusion revealing cardiac amyloidosis in the course of rheumatoid arthritis].
Pericardial effusion is common in patients with rheumatoid arthritis. It is essentially a sign of pericardial involvement of the rheumatoid disease, but viral, bacterial and especially tuberculous pericarditis must not be excluded. Pericardial amyloidosis of the AA type is much less common and difficult to diagnose before cardiac biopsy even in cases of myocardial amyloidosis, as in the reported case, in which the classical association of microvoltage on the ECG and myocardial hypertrophy on echocardiography was absent. The absence of myocardial uptake of technetium-labelled pyrophosphates at myocardial scintigraphy and the absence of a restrictive profile on cardiac gamma-angiography were not suggestive of the diagnosis of amyloidosis. Pericardial and endomyocardial biopsy, justified by the negativity of the preceding investigations, provided an accurate histological diagnosis, a prognostic evaluation and was also useful for guiding management.
Giraudeau
C
C
Service de cardiologie B, hôpital Trousseau, Tours.
Babuty
D
D
Goupille
P
P
Casset-Senon
D
D
de Muret
A
A
Fauchier
L
L
Hurreesing
C
C
Valat
J P
JP
Cosnay
P
P
D000368:Aged; D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000503:physiopathology; D001706:Biopsy; D006332:Cardiomegaly / Q000175:diagnosis / Q000503:physiopathology; D004378:Duodenal Diseases / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D010490:Pericardial Effusion / Q000209:etiology*; D013902:Radiography, Thoracic