del Fresno M Rosa, Peralta Julio E, Granados Miguel Ángel, Enríquez Eugenia, Domínguez-Pinilla Nerea, de Inocencio Jaime
Pediatric Rheumatology Unit and
Division of Pediatric Cardiology, Department of Pediatrics, Hospital Universitario Doce de Octubre, Madrid, Spain.
Pediatrics. 2014 Nov;134(5):e1441-6. doi: 10.1542/peds.2013-3900. Epub 2014 Oct 6.
Recurrent pericarditis is a troublesome complication of idiopathic acute pericarditis and occurs more frequently in pediatric patients after cardiac surgery (postpericardiotomy syndrome). Conventional treatment with nonsteroidal antiinflammatory drugs, corticosteroids, and colchicine is not always effective or may cause serious adverse effects. There is no consensus, however, on how to proceed in those patients whose disease is refractory to conventional therapy. In such cases, human intravenous immunoglobulin, immunosuppressive drugs, and biological agents have been used. In this report we describe 2 patients with refractory recurrent pericarditis after cardiac surgery who were successfully treated with 3 and 5 monthly high-dose (2 g/kg) intravenous immunoglobulin until resolution of the effusion. Our experience supports the effectiveness and safety of this therapy.
复发性心包炎是特发性急性心包炎的一种棘手并发症，在心脏手术后的儿科患者中更常见（心包切开术后综合征）。使用非甾体类抗炎药、皮质类固醇和秋水仙碱进行的传统治疗并不总是有效，或者可能会引起严重的不良反应。然而，对于那些对传统治疗难治的患者如何进行治疗，目前尚无共识。在这种情况下，已使用人静脉注射免疫球蛋白、免疫抑制药物和生物制剂。在本报告中，我们描述了2例心脏手术后难治性复发性心包炎患者，他们每月接受3次和5次大剂量（2 g/kg）静脉注射免疫球蛋白治疗，直至积液消退，治疗成功。我们的经验支持了这种治疗方法的有效性和安全性。
