[Is chronic or recurrent idiopathic pericarditis an autonomous inflammatory disease?].
OBJECTIVE
Chronic pericarditis or recurrent pericarditis is mostly considered to be idiopathic even when up-to-date medical investigations are undertaken. The absence of aetiology and the associated inflammatory process are features of a common disease for internists. As there are only a few published reports on this disease, therapeutic options are not easily envisaged.


BACKGROUND
Idiopathic pericarditis and its evolution, characterized by recurrence or chronicity, has long been diagnosed and studied. Faced with a case of acute pericarditis, no clinical or biological data can preclude evolution towards a chronic or a recurrent form. The two major complications are tamponade and constriction. Classical treatment is aspirin and nonsteroidal anti-inflammatories. Steroids have a spectacular effect but steroid dependence is frequently observed. Colchicine treatment seems to be efficacious and can be used to stop steroid therapy. There are only a few published reports on the importance of immunosuppressive drugs such as azathioprine and cyclophosphamide.


CONCLUSIONS
Through our own experience and literature review, we propose to consider chronic and/or recurrent pericarditis as an autonomous inflammatory disease of the pericardium. Thus, large-scale studies concerning the treatment should improve the outcome of patients.
Granel
B
B
Service de médecine interne, hôpital de la Timone, CHU, 264, rue Saint-Pierre, 13385 Marseille, France.
Serratrice
J
J
Rey
J
J
Pache
X
X
Swiader
L
L
Habib
G
G
Mesana
T
T
Ene
N
N
Disdier
P
P
Weiller
P J
PJ
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002908:Chronic Disease; D003078:Colchicine / Q000627:therapeutic use; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012008:Recurrence
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin; D003078:Colchicine