title: Usefulness of Novel Immunotherapeutic Strategies for Idiopathic Recurrent Pericarditis.
abstract: Idiopathic recurrent pericarditis (IRP) is a debilitating illness which leads to great suffering and multiple hospitalizations. Management of acute pericarditis and subsequent recurrences has evolved significantly as the use of colchicine-based strategies become more prevalent, yet there still remains a subset of patients who remain refractory to colchicine therapy, and these patients require prolonged corticosteroid (CS) therapy for the control of symptoms. Since the 1960s, there have been reports of successful management of these cases with immunosuppressive therapy. Current guidelines support the use of anakinra, intravenous immunoglobulins, and azathioprine for management of IRP, with the goals of both control of symptoms and withdrawal of CS. Recent reports supply evidence for both auto-inflammatory and autoimmune activity in these patients. We herein review the current available reports regarding the evidence regarding the pathophysiology and reported cases and case series of IRP cases managed with immunomodulation therapy.
authors.affiliation: Department of Internal Medicine T, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel. Electronic address: dor.lotan@sheba.health.gov.il.
authors.forename: Dor
authors.initials: D
authors.lastname: Lotan
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yishay
authors.initials: Y
authors.lastname: Wasserstrum
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Internal Medicine D, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Fardman
authors.affiliation: Department of Internal Medicine T, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Kogan
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hospital Management Department, Chaim Sheba Medical Center, Tel Ha'Shomer, Ramat Gan, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Adler
mesh_terms: D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007167:Immunotherapy / Q000592:standards*; D010493:Pericarditis / Q000188:drug therapy*; D017410:Practice Guidelines as Topic / Q000592:standards*; D012008:Recurrence
chemical_list: D007155:Immunologic Factors