Evard D, Baglin A, Gueret P, Farcot J C, Rey L P, Paolaggi J B
Sem Hop. 1983 Nov 10;59(41):2835-7.
The authors report the case of seventy-two-year-old man with severe rheumatoid arthritis in whom onset of right ventricular failure led to the discovery of pericarditis. After fluid withdrawal, the anterior part of the pericardium was resected. Analysis of the fluid and histological findings suggested a rheumatoid origin. Pericarditis recurred two and a half years later causing subacute compression of the heart leading to repeated centeses in spite of corticosteroid therapy. In the terminal stage, M. tuberculosis was discovered but this finding was not confirmed subsequently. The main features of rheumatoid pericarditis are reviewed. Tuberculous pericarditis should be considered in patients under corticosteroids or immunosuppressive agents.
作者报告了一例72岁患有严重类风湿性关节炎的男性病例,该患者右心室衰竭的发作导致了心包炎的发现。在抽液后,切除了心包的前部。对液体的分析和组织学检查结果提示为类风湿性病因。两年半后心包炎复发,导致心脏亚急性受压,尽管进行了皮质类固醇治疗仍需反复穿刺。在终末期,发现了结核分枝杆菌,但随后这一发现未得到证实。本文对类风湿性心包炎的主要特征进行了综述。对于使用皮质类固醇或免疫抑制剂的患者,应考虑结核性心包炎。