Abstract：
:Recurrent pericarditis is one of the most troublesome complications of pericarditis occurring in about one third of patients with a previous attack of pericarditis. The pathogenesis is presumed to be autoimmune and/or autoinflammatory in most cases. The mainstay of therapy for recurrences is physical restriction and anti-inflammatory therapy based on aspirin or NSAID plus colchicine. Corticosteroids at low to moderate doses (e.g., prednisone 0.2 to 0.5 mg/kg/day) should be considered only after failure of aspirin/NSAID (and more than one of these drugs) or for specific indications (e.g., pregnancy, systemic inflammatory diseases on steroids, renal failure, concomitant oral anticoagulant therapy). One of the most challenging issues is how to cope with patients who have recurrences despite colchicine. A small subset of patients (about 5 %) may develop corticosteroid-dependence and colchicine resistance. Among the emerging treatments, the three most common and evidence-based therapies are based on azathioprine, human intravenous immunoglobulin (IVIG), and anakinra. After failure of all options of medical therapy or for those patients who do not tolerate medical therapy or have serious adverse events related to medical therapy, the last possible option is the surgical removal of the pericardium. Total or radical pericardiectomy is recommended in these cases in experienced centers performing this surgery. A stepwise approach is recommended starting from NSAID and colchicine, corticosteroid and colchicine, a combination of the three options (NSAID, colchicine and corticosteroids), then azathioprine, IVIG, or anakinra as last medical options before pericardiectomy.
journal_name
Curr Cardiol Repjournal_title
Current cardiology reportsauthors
Imazio M,Adler Y,Charron Pdoi
10.1007/s11886-016-0727-8subject
Has Abstractpub_date
2016-06-01 00:00:00pages
50issue
6eissn
1523-3782issn
1534-3170pii
10.1007/s11886-016-0727-8journal_volume
18pub_type
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journal_title：Current cardiology reports
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pub_type： 杂志文章,评审
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journal_title：Current cardiology reports
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更新日期：2014-07-01 00:00:00
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pub_type： 杂志文章,评审
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2004-09-01 00:00:00
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journal_title：Current cardiology reports
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更新日期：2019-09-13 00:00:00
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pub_type： 杂志文章,评审
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2014-01-01 00:00:00
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更新日期：2002-03-01 00:00:00
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journal_title：Current cardiology reports
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更新日期：2017-08-01 00:00:00
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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journal_title：Current cardiology reports
pub_type： 杂志文章,评审
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更新日期：2020-10-21 00:00:00
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