Sève Pascal, Stankovic Katia, Broussolle Christiane
Department of Internal Medicine, Hôtel-Dieu, 1 place de l'Hôpital, 69288, Lyon Cedex 02, France.
Rheumatol Int. 2005 Sep;25(7):558-61. doi: 10.1007/s00296-004-0572-8. Epub 2005 Jan 11.
Survival is impaired in rheumatoid pericarditis complicated by cardiac compression by either tamponade or constriction. Conventional therapy with non-steroidal anti-inflammatory agents and glucocorticoids is frequently ineffective in reversing severe cardiac impairment and/or in preventing recurrences. Colchicine, an effective and safe treatment of idiopathic and post-viral pericarditis, has not been studied in rheumatoid pericarditis. We describe the case of a 44-year-old woman with a 1-year history of rheumatoid arthritis who developed rheumatoid pericarditis complicated with tamponade. Pericardiocentesis relieved the symptoms, but pericarditis recurred at a high dose of prednisone of 70 mg/day. Colchicine at a dose of 1 mg/day prevented recurrences and had a significant sparing effect on steroids, which were reduced to 6 mg/day. This is the second case report describing the effectiveness of colchicine therapy in rheumatoid pericarditis complicated with tamponade. These cases suggest that colchicine should be considered in the treatment of rheumatoid pericarditis.
类风湿性心包炎若并发心脏受压（无论是心包填塞还是缩窄），生存率会降低。使用非甾体抗炎药和糖皮质激素的传统疗法在逆转严重心脏损害和/或预防复发方面往往无效。秋水仙碱是特发性和病毒性心包炎的有效且安全的治疗方法，但尚未在类风湿性心包炎中进行研究。我们描述了一名44岁女性的病例，她有1年类风湿性关节炎病史，并发类风湿性心包炎并伴有心包填塞。心包穿刺术缓解了症状，但在泼尼松剂量为70mg/天时心包炎复发。每天1mg剂量的秋水仙碱预防了复发，并对类固醇有显著的减量作用，类固醇剂量减至6mg/天。这是第二例描述秋水仙碱治疗并发心包填塞的类风湿性心包炎有效性的病例报告。这些病例表明，在类风湿性心包炎的治疗中应考虑使用秋水仙碱。
