1/23. Steroid-responsive pleuropericarditis and livedo reticularis in an unusual case of adult-onset primary hyperoxaluria.We present a case of a 54-year-old woman with rapidly progressive renal failure of uncertain origin, who developed pleuropericarditis and livedo reticularis 6 weeks after initiation of hemodialysis (HD). The presentation with acute renal failure, the development of serositis, and the dramatic clinical response to empiric steroid therapy initially suggested the diagnosis of a systemic inflammatory disorder or vasculitis. Renal biopsy, performed 3 days after presentation, suggested crystal deposition disease, and subsequent investigations, using both dialysate oxalate concentrations and liver biopsy, led to the diagnosis of primary hyperoxaluria (PH). We discuss this atypical adult presentation of PH and propose a role for the use of steroids in the management of the acute inflammatory symptoms of oxalosis. We also briefly discuss the current medical management of patients with PH, including transplantation.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
2/23. The postpericardiotomy syndrome as a cause of pleurisy in rehabilitation patients.Pleuritic chest pain in patients on a rehabilitation unit may be caused by several conditions. We report 2 cases of postpericardiotomy syndrome (PPS) as a cause of pleuritic pain. PPS occurs in 10% to 40% of patients who have coronary bypass or valve replacement surgery. The syndrome is characterized by fever, chest pain, and a pericardial or pleural friction rub. Its etiology is believed to be viral or immunologic. The syndrome can be a diagnostic challenge, and an increase in length of hospitalization because of it has been documented. Identified risk factors for PPS include age, use of prednisone, and a history of pericarditis. A higher incidence has been reported from May through July. Many patients undergo a battery of expensive procedures before PPS is diagnosed. The pain is sharp, associated with deep inspiration, and changes with position. Pleural effusions may be present and tend to occur bilaterally. Pericardial effusions are a documented complication. A pericardial or pleural rub may be present and is often transient. Serial auscultation is important. Laboratory work provides clues with a mild leukocytosis and an elevated erythrocyte sedimentation rate. However, this does not provide the definitive diagnosis. Cardiac enzymes are not reliably related to the syndrome. An electrocardiogram will show changes similar to those associated with pericarditis. The patient may have a fever, but it is rarely higher than 102.5 degrees F. Complications include pericardial effusions, arrhythmias, premature bypass graft closure, and cardiac tamponade. Treatment consists of a 10-day course of nonsteroidal anti-inflammatory drugs.- - - - - - - - - - ranking = 0.4keywords = pericarditis (Clic here for more details about this article) |
3/23. myiasis due to Hypoderma lineatum infection mimicking the hypereosinophilic syndrome.myiasis is the infestation of live humans with larvae of diptera (true flies). This report describes a protracted illness caused by infestation with Hypoderma lineatum, resembling the hypereosinophilic syndrome. A 35-year-old man had a 9-month multisystemic illness with pronounced eosinophilia, pleuritis, pericarditis, and myositis. Treatments including glucocorticoids did not alter the disease. Diagnostic studies included computed tomography, 2-dimensional echocardiography, leukocyte count, surgical biopsy of skin and muscle, blood immunoglobulin levels, and blood chemistry. myiasis was recognized when a worm emerged from the patient's skin; after a second worm emerged, the patient's symptoms disappeared rapidly. Other determinations included IgE and IgG levels specific for H lineatum, Western blot, and immunofluorescence for eosinophil major basic protein; IgG antibodies to H lineatum decreased after emergence of the worms. The patient's symptoms mimicked the hypereosinophilic syndrome but resolved when the myiasis became apparent. Specific serologic analyses can identify infected patients, and ivermectin may be useful as treatment.- - - - - - - - - - ranking = 0.2keywords = pericarditis (Clic here for more details about this article) |
4/23. Group-F streptococcal pleuro-pericarditis in a mesothelioma patient after dental surgery (case report).A 71-year-old mesothelioma patient developed pleuro-pericarditis and pleural empyema. Bacteriological examinations and serological identification proved group F streptococcus in the pleural fluid. Anamnestic data suggested that the source of infection might have been the oral cavity after dental surgery.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
5/23. Pleuropericarditis and disseminated intravascular coagulation in ulcerative colitis.We report a 30-year-old woman with pleuropericarditis, cardiac tamponade, and disseminated intravascular coagulation complicating active ulcerative colitis (UC). Other autoimmune diseases were not present. She responded to pulsed steroid therapy and anticoagulant with resolution of the complication and UC. We reviewed the literature and found 27 cases of pleuropericarditis associated with idiopathic inflammatory bowel disease (IBD). It has been reported that pleuropericarditis associated with IBD responds well to nonsteroidal antiinflammatory drugs, as well as steroids. The causes of cardiac involvement in IBD remain unclear, but the pleuropericarditis must be recognized as a potential extraintestinal manifestation of IBD.- - - - - - - - - - ranking = 1.6keywords = pericarditis (Clic here for more details about this article) |
6/23. Pulmonary actinomycosis followed by pericarditis and intractable pleuritis.A case of pleuropericarditis caused by actinomyces israelli is described. The patient first underwent left upper lobectomy because of pulmonary actinomycosis. Seven months later, cardiac tamponade developed. culture of the bloody pericardial effusion resulted in positive growth of actinomyces israeli. He was successfully treated with penicillin g, ampicillin, and minocyclin. However, right pleural effusion appeared two months later. Cultures of the effusion again yielded positive growth of the same bacteria. However, the strain had gained resistance to any antibiotics that had been effective before. Accordingly, pleurodesis with minocyclin was undertaken, which was fortunately effective for controlling the pleural effusion.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
7/23. Pleuritis-pericarditis--an unusual initial manifestation of mixed connective tissue disease.Cardiac involvement has been reported in mixed connective tissue disease (MCTD). We describe a 16-year-old girl in whom pleuritis and pericarditis occurred as the initial clinical manifestations of MCTD. Although pleuritis and pericarditis form a common clinical entity in MCTD, it is rarely seen as an initial manifestation. If MCTD is suspected, the diagnosis can be made by the clinical findings and the occurrence of a high titre of antibody against ribonuclease-sensitive ribonucleoprotein (RNP). This report emphasizes the importance of screening for connective tissue disease in patients with pericarditis/pleuritis.- - - - - - - - - - ranking = 1.4keywords = pericarditis (Clic here for more details about this article) |
8/23. Metal fume fever presenting as aseptic meningitis with pericarditis, pleuritis and pneumonitis.BACKGROUND: Metal fume fever (MFF) is a well-known complication of zinc oxide fume inhalation. Prompt recognition of this condition is essential for the proper medical management of this self-limited disease. AIM: To present a unique and unusual case of MFF. RESULTS: Our patient is a 25-year-old male welder who had MFF and presented with aseptic meningitis with pericarditis, pleuritis and pneumonitis. To our knowledge, this is the first case of MMF presenting with these signs and symptoms. CONCLUSIONS: MFF can present with a systemic inflammatory response causing a multi-organ serositis. Our case highlights the utmost importance of obtaining an occupational history on all our patients, even if they are critically ill.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
9/23. A case of refractory uremic pleuropericarditis--successful corticosteroid treatment.We report the case of a patient with uremic pleuropericarditis who showed a marked improvement following corticosteroid therapy. A 66-year-old man who had been on hemodialysis therapy for 13 years was admitted to our hospital presenting with increases in bilateral pleural effusions and pericardial effusion. Repeated thoracentesis showed hemorrhagic and exudative findings. Pleural and pericardial fluid cytologic examination, bacterial culture and acid-fast staining showed negative findings. Despite the administration of antibiotics and antituberculosis drugs, low-grade fever continued and c-reactive protein level remained high. A pleural biopsy revealed fibrinous pleuritis without infectious disease or malignancy. He was diagnosed as having uremic pleuropericarditis on the basis of the clinicopathological features, but had been unresponsive to conventional treatments including repeated thoracentesis and the continuance of hemodiafiltration using nafamostat mesylate. Ultimately, both pleural and pericardial effusions were controlled after the treatment with prednisolone at an initial dose of 50 mg per day. In conclusion, corticosteroid therapy seems to be useful for treating patients with conventional therapy-resistant uremic pleuropericarditis.- - - - - - - - - - ranking = 1.4keywords = pericarditis (Clic here for more details about this article) |
10/23. pericarditis and pleuritis caused by extramedullary plasmacytoma.The following illustrates a case study of a 9 years-old girl with combined pericarditis and pleuritis caused by solitary extramedullary plasmacytoma. pericardiocentesis and permanent thoracocentesis were performed, both yielded serohemorrhagic and serous fluid in succession. In the beginning etiological diagnosis was made on the basis of the clinical pattern for tuberculosis infection and growth of three species of bacteria for bacterial infections and candida species for candidiasis. The initial treatment was in accordance with the etiological diagnosis mentioned above. The final diagnosis was establish in the fourth month after the discovery of plasmacytoma in the pleural fluid and CT scan examination disclosing masses in the right lung. Accordingly, cytostatic therapy was started. The result of therapy was very good, exudation into the pleural and pericardial sac regressed gradually and eventually ceased completely. According to the literature the prognosis of these neoplasma is good.- - - - - - - - - - ranking = 0.2keywords = pericarditis (Clic here for more details about this article) |
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