Department of Medicine V, Amyloidosis Center and Division of Haematology, Oncology and Rheumatology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
Curr Rheumatol Rep. 2019 Mar 9;21(5):18. doi: 10.1007/s11926-019-0820-2.
Idiopathic acute and recurrent pericarditis are rare diseases of unknown origin. Here, we review trigger factors, pathomechanism, and treatment options for acute and recurrent pericarditis.
Acute pericarditis can be triggered by viral infections, myocardial ischemia, heart catheter interventions, cardiac surgery or seem to occur without any trigger. Earlier reports about viral nucleic acids in the effusion or myocardial autoantibodies in serum were detected only in a minority of patients. The current pathomechanistic concept focuses on the innate immune system. Clinical trials revealed that colchicine and anti-IL1β-targeted medication were effective to control acute and recurrent attacks. Activation of the innate immune system in pericarditis suggests that autoinflammation contributes to acute and recurrent pericarditis. The efficacy of colchicine and anti-IL1β-targeted medication in clinical trials indicates that acute and recurrent pericarditis should be regarded as an autoinflammatory disease. Therefore, idiopathic pericarditis should be considered as an autoinflammatory disease.
特发性急性和复发性心包炎是病因不明的罕见疾病。在此，我们回顾急性和复发性心包炎的诱发因素、发病机制和治疗选择。
急性心包炎可由病毒感染、心肌缺血、心导管介入、心脏手术引起，也可无明显诱因发生。早期关于渗出液中病毒核酸或血清中心肌自身抗体的报道仅在少数患者中被检测到。目前的发病机制概念侧重于固有免疫系统。临床试验表明，秋水仙碱和抗 IL1β 靶向药物可有效控制急性和复发性发作。心包炎固有免疫系统的激活表明自身炎症与急性和复发性心包炎有关。秋水仙碱和抗 IL1β 靶向药物在临床试验中的疗效表明，急性和复发性心包炎应被视为自身炎症性疾病。因此，特发性心包炎应被视为一种自身炎症性疾病。
