Colchicine as an effective treatment for postpericardiotomy syndrome following a lung lobectomy.
Postpericardiotomy syndrome (PPS) is a frequent complication of various cardiac procedures that involve entry into the pericardium, but rarely occurs after pulmonary surgery because the pericardium is usually preserved during this procedure. The standard treatment for PPS is the administration of non-steroidal anti-inflammatory drugs (NSAIDs). Recent studies have indicated however, that colchicine may be useful for the treatment and prevention of this syndrome. Here, we describe the successful use of colchicine to treat PPS in a lung cancer patient who developed this complication following a lung lobectomy. A 64-year-old woman with a stage IA lung tumor underwent a left upper lobectomy with a mediastinal lymph node dissection. Severe precordial pain occurred 10 days after surgery, and accumulations of pericardial and pleural fluid were revealed by chest X-ray, echocardiogram, and chest computed tomography. These symptoms were not alleviated by antibiotics, thoracic cavity drainage, or NSAIDs. However, the administration of colchicine (initial dose of 1.0 mg and maintenance dose of 0.5 mg daily for three months) in combination with NSAIDs resolved these symptoms immediately after the first dosage. In addition, the patient remains free of any recurrent pericarditis at six months after this episode.
Eguchi
Takashi
T
Department of Thoracic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Japan. tks1976@shinshu-u.ac.jp
Yoshida
Kazuo
K
Hamanaka
Kazutoshi
K
Kurai
Makoto
M
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003078:Colchicine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011185:Postpericardiotomy Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D003078:Colchicine