Vol. 13. Núm. 43.
Páginas 2532-2539 (Noviembre 2021)

Pericarditis recurrente

Recurrent pericarditis

O. Otero GarcíaaC. Abou-Jokh CasasaA. Martínez MonzonísabT. González FerreroaJ.R. González-Juanateyab
Doi : https://10.1016/j.med.2021.10.004
Opciones
Resumen

La pericarditis recurrente es aquella en la que hay evidencia de un nuevo episodio de pericarditis, tras un período libre de síntomas de al menos 4-6 semanas, después de un primer diagnóstico de pericarditis aguda. La tasa de recurrencias es variable, y puede ocurrir hasta en la mitad de los casos después de una primera recurrencia en pacientes que reciben un tratamiento inadecuado. La fisiopatología es controvertida, y se ha postulado que un agente infeccioso actúa como desencadenante de una respuesta autoinmune o autoinflamatoria en pacientes susceptibles. Los criterios diagnósticos no difieren en gran medida de los empleados para el diagnóstico de un primer episodio de pericarditis aguda, y el tratamiento es superponible al tratamiento del episodio inicial. Sin embargo, en caso de múltiples recurrencias, deben tenerse en cuenta otras opciones terapéuticas, entre las que se encuentran los corticoides y los inmunosupresores y, como última opción, la pericardiectomía.

Palabras clave
Pericardio
Pericarditis recurrente
Autoinmune
Colchicina
Anakinra
Abstract

Recurrent pericarditis is pericarditis in which there is evidence of a new pericarditis episode following a symptoms-free period of at least four to six weeks following an initial diagnosis of acute pericarditis. The recurrence rate varies and it can occur in up to half of cases following a first recurrence in patients who receive inadequate treatment. The pathophysiology is controversial. It has been postulated that an infectious agent may trigger an autoimmune or autoinflammatory response in susceptible patients. The diagnostic criteria do not differ greatly from those used to diagnose an initial episode of acute pericarditis and treatment is able to be added to the treatment for the initial episode. However, in the case of multiple recurrences, other treatment options must be taken into account, included glucocorticoids and immunosuppressive agents and, as a last option, a pericardiectomy.

Keywords
Pericardium
Recurrent pericarditis
Autoimmune
Colchicine
Anakinra

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