Successful treatment of refractory cardiac tamponade due to rheumatoid arthritis using pericardial drainage.
Rheumatoid pericarditis occurs in patients with rheumatoid arthritis (RA). However, cardiac tamponade due to rheumatoid pericarditis is rare; we describe a case of a 72-year-old man with a 6-year history of rheumatoid arthritis who developed rheumatoid pericarditis with recurrent cardiac tamponade. The patient experienced relapse of the cardiac tamponade despite treatment with pericardiocentesis. Therefore, the patient underwent surgical pericardial drainage. The patient was also subsequently treated with increasing doses of corticosteroid, methotrexate and leukocytapheresis. These treatments resulted in a successful outcome without any complication. This case suggests that in addition to immunosuppressive therapy, pericardial drainage should be considered in the treatment of life-threatening refractory cardiac tamponade caused by rheumatoid arthritis.
Imadachi
Hiroko
H
Department of General Internal Medicine, NHO National Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki 856-8562, Japan.
Imadachi
Shunsuke
S
Koga
Tomohiro
T
Miyashita
Taichiro
T
Izumi
Yasumori
Y
Takayama
Hayato
H
Nakamichi
Chikaaki
C
Hamawaki
Masayoshi
M
Yamaguchi
Hiroshi
H
Matsukuma
Seiji
S
Ito
Masahiro
M
Maeda
Kazushige
K
Motokawa
Satoru
S
Sasaki
Osamu
O
Migita
Kiysohi
K
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002305:Cardiac Tamponade / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D010493:Pericarditis / Q000209:etiology* / Q000601:surgery*; D013396:Suction / Q000379:methods*; D016896:Treatment Outcome