title: Hepatitis C virus-associated pericardial effusion and tamponade in a liver transplant recipient.
abstract: 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.
authors.affiliation: West Penn-Allegheny Health System, Pittsburgh, Pennsylvania, USA. lnikolai@wpahs.org
authors.forename: Lazaros A
authors.initials: LA
authors.lastname: Nikolaidis
authors.forename: Maher
authors.initials: M
authors.lastname: Azzouz
authors.forename: Lois
authors.initials: L
authors.lastname: Friedlander
authors.forename: David H
authors.initials: DH
authors.lastname: Van Thiel
authors.forename: Alan H
authors.initials: AH
authors.lastname: Gradman
mesh_terms: 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