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Idiopathic Recurrent Pericarditis

  • Massimo Imazio
  • Anna Valenti
  • Antonio Brucato
  • Alberto MartiniEmail author
Chapter

Abstract

Idiopathic recurrent pericarditis (IRP) is a subset of pericarditis characterized by frequent true recurrences (free interval between two flares longer than 4 weeks). The term “idiopathic” refers to a non-specific etiology and is used even if an autoinflammatory pathway is suspected. The diagnosis is based on the association of typical symptoms and signs (mainly pericardial chest pain plus pericardial rub or electrocardiographic alterations or pericardial effusion). The monitoring of inflammatory markers and the use of imaging techniques help to guide management. Standard treatment includes the combination of non-steroidal anti-inflammatory drugs (NSAIDs) plus colchicine. In cases that do not respond to this combination, therapy with interleukin-1 inhibition has been remarkably effective.

Keywords

Pericarditis Recurrent pericarditis Autoimmune diseases Autoinflammatory diseases Colchicine Immunotherapy Anakinra Echocardiography Cardiac magnetic resonance 

Abbreviations

AHA

Anti-heart antibodies

AIDA

Anti-intercalated-disk antibodies

AIRTRIP

The Anakinra-Treatment of Recurrent Idiopathic Pericarditis

ANA

Anti-nuclear antibodies

AP-1

Activator protein-1

APC

Antigen-presenting cell

ASA

Acetylsalicylic acid

CEACAM1

Carcinoembryonic antigen cell adhesion molecule 1

CMR

Cardiac magnetic resonance

CMV

Cytomegalovirus

CRP

C-reactive protein

CT

Computerized tomographic

DAMP

Damage-associated molecular patterns

EBV

Epstein-Barr virus

ECG

Electrocardiogram

ESC

European Society of Cardiology

ESR

Erythrocyte sedimentation rate

HCV

Hepatitis C virus

HIV

Human immunodeficiency virus

HLA

Human leukocyte antigens

HSV-1

Herpes simplex virus

IL

Interleukin

INF

Interferon γ

IRP

Idiopathic recurrent pericarditis

IVIg

Intravenous immunoglobulins

MHC

Major histocompatibility complex

MICA

MHC class I chain related protein A

NF-kB

Nuclear factor-kappa B

NSAIDs

Nonsteroidal anti-inflammatory drugs

PAMP

Pathogen-associated molecular patterns

PPS

Postpericardiotomy syndrome

STIR

Short-tau inverted recovery

TLR

Toll-like receptor

TNF

Tumor necrosis factor

TRAPS

TNF receptor-associated periodic fever syndrome

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Massimo Imazio
    • 1
  • Anna Valenti
    • 2
  • Antonio Brucato
    • 2
  • Alberto Martini
    • 3
    Email author
  1. 1.University Cardiologia AOU Citta’della Salute e Della Scienza di TorinoTorinoItaly
  2. 2.Medicina Interna Ospedale Papa Giovanni XXIIIBergamoItaly
  3. 3.IRCCS Giannina Gaslini, Università di GenovaGenoaItaly

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