Hepatitis C virus-associated pericardial effusion and tamponade in a liver transplant recipient.
A liver transplant recipient with hepatitis C presented with unexplained dyspnea, fatigue and edema. Diagnostic evaluation revealed a pericardial effusion with echocardiographic features of tamponade. The patient underwent therapeutic pericardial drainage, resulting in symptomatic relief. The pericardial fluid tested positive for hepatitis C virus (viral quantitation of 200,000 copies/mL, genotype 1b) and negative for other plausible etiologies. Pericardial biopsy revealed normal tissue. This is the fifth case of hepatitis C virus-associated pericardial disease worldwide and the first case in North America. It is the first in a liver transplant recipient. In contrast to previous reports, this patient demonstrated tamponade in the absence of cryoglobulinemia or systemic extrahepatic manifestations of hepatitis C.
Nikolaidis
Lazaros A
LA
West Penn-Allegheny Health System, Pittsburgh, Pennsylvania, USA. lnikolai@wpahs.org
Azzouz
Maher
M
Friedlander
Lois
L
Van Thiel
David H
DH
Gradman
Alan H
AH
D000328:Adult; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000821:virology*; D015150:Echocardiography, Doppler; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D010490:Pericardial Effusion / Q000175:diagnosis / Q000821:virology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000821:virology