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2.
Medicina (Kaunas) ; 55(10)2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31547038

RESUMO

Background and Objectives: Recurrence of pericarditis (ROP) is an important complication of the acute pericarditis. The aim of this study was to analyse the influence of aetiology, clinical findings and treatment on the outcome of acute pericarditis. Methods: Data were retrospectively collected from medical records of patients treated from 2011 to 2019 at a tertiary referent heart paediatric center. Results: Our investigation included 56 children with idiopathic and viral pericarditis. Relapse was registered in 8/56 patients, 2/29 (7.41%) treated with nonsteroidal anti-inflammatory drugs (NSAID) and 6/27 (28.57%) treated with corticosteroids (CS) and NSAID. Independent risk factors for ROP were viral pericarditis (p = 0.01, OR 31.46), lack of myocardial affection (p = 0.03, OR 29.15), CS use (p = 0.02, OR 29.02) and ESR ≥ 50 mm/h (p = 0.03, OR 25.23). In 4/8 patients the first recurrence was treated with NSAID and colchicine, while treatment of 4/8 patients included CS. Children with ROP treated with CS had higher median number of recurrence (5, IQR: 2-15) than those treated with colchicine (0, IQR: 0-0.75). Conclusions: Independent risk factors for recurrence are CS treatment, viral aetiology, pericarditis only and ESR ≥ 50 mm/h. Acute pericarditis should be treated with NSAID. Colchicine and NSAID might be recommended in children with the first ROP.


Assuntos
Corticosteroides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Colchicina/uso terapêutico , Pericardite/tratamento farmacológico , Doença Aguda , Adolescente , Sedimentação Sanguínea , Criança , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pericardite/etiologia , Pericardite/virologia , Recidiva , Estudos Retrospectivos , Fatores de Risco
3.
BMJ Case Rep ; 12(8)2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31420437

RESUMO

A 60-year-old woman was admitted to the hospital with worsening dyspnoea, cough and chest pain. This was on a background of weight loss, decreased appetite, mononeuritis multiplex, chronic eosinophilia and a single episode of a non-blanching rash. Investigations demonstrated a raised troponin and ischaemic changes on ECG, and she was therefore initially treated for a presumed myocardial infarction. However, her symptoms failed to improve with treatment for the acute coronary syndrome. A coronary angiogram revealed no significant flow-limiting disease, and further investigations yielded confirmation of raised eosinophils and a positive perinuclear antineutrophil cytoplasmic antibody test. An echocardiogram demonstrated a pericardial effusion, and subsequent cardiac magnetic resonance features were compatible with myopericarditis. In light of these findings, the patient was diagnosed with eosinophilic granulomatous with polyangiitis and commenced on high-dose intravenous methylprednisolone and cyclophosphamide. She made an excellent recovery and remains in remission on azathioprine and a tapering dose of corticosteroids.


Assuntos
Granuloma Eosinófilo/complicações , Granulomatose com Poliangiite/complicações , Miocardite/etiologia , Pericardite/etiologia , Anti-Inflamatórios/administração & dosagem , Ciclofosfamida/administração & dosagem , Granuloma Eosinófilo/tratamento farmacológico , Feminino , Granulomatose com Poliangiite/tratamento farmacológico , Humanos , Imunossupressores/administração & dosagem , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Miocardite/tratamento farmacológico , Pericardite/tratamento farmacológico
4.
Am J Case Rep ; 20: 975-979, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31281180

RESUMO

BACKGROUND Candida albicans is the principal human fungal opportunistic organism commonly detected in the gastrointestinal and genitourinary systems. Five species of candida (Glabrata, Tropicalis, Albicans, Parapsilosis, and Kruzei) are responsible for most cases of invasive candidiasis or candidemia, which is a growing public health concern due to the increasing complexity of patients, leading to a high fatality rate. CASE REPORT We report an extremely rare case of candida pericarditis due to esophagopericardial fistula in a young, heavy, alcoholic adult diagnosed by culture of the drained pericardial fluid, which showed a growth of Candida albicans. CONCLUSIONS We highlight the first case of candida pericarditis in immunocompetent adult successfully treated by pericardiocentesis and oral fluconazole.


Assuntos
Candida albicans/isolamento & purificação , Candidemia/microbiologia , Fístula Esofágica/complicações , Pericardite/microbiologia , Adulto , Antifúngicos/uso terapêutico , Candida albicans/efeitos dos fármacos , Candidemia/tratamento farmacológico , Candidemia/cirurgia , Dor no Peito , Fluconazol/uso terapêutico , Humanos , Hospedeiro Imunocomprometido , Masculino , Pericardiocentese , Pericardite/tratamento farmacológico , Pericardite/cirurgia
5.
BMC Infect Dis ; 19(1): 657, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337357

RESUMO

BACKGROUND: Eikenella corrodens is a slowly growing gram-negative bacillus that can cause severe invasive disease in human. Although E. corrodens infections in various sites of human body have been well described, pericarditis caused by invasive E. corrodens has rarely been reported. CASE PRESENTATION: Here we report the case of a 63-year old male with a complaint of left shoulder pain. The patient was diagnosed as purulent pericarditis by chest computed tomography scan and ultrasound-guided pericardiocentesis, and the pathogen of E. corrodens was identified in the pericardial fluid culture. The clinical condition of the patient deteriorated quickly, and he died right after the drainage surgery even though the pathogen was sensitive to antibiotics treatment. CONCLUSION: E. corrodens is a rare pericarditis associated pathogen. Purulent pericarditis caused by E. corrodens presents atypical manifestations and rapid progression of infection in immunosuppressed individuals such as neutropenic patients. Earlier diagnosis and proper drainage surgery with effective antibiotics treatment may improve the prognosis.


Assuntos
Eikenella corrodens/patogenicidade , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Pericardite/tratamento farmacológico , Antibacterianos/uso terapêutico , Eikenella corrodens/efeitos dos fármacos , Feminino , Infecções por Bactérias Gram-Negativas/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Pericardiocentese , Pericardite/diagnóstico por imagem , Pericardite/cirurgia , Tomografia Computadorizada por Raios X
6.
BMJ Case Rep ; 12(6)2019 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-31167767

RESUMO

Immune checkpoint inhibitors, such as pembrolizumab, have significantly improved cancer patient outcome. Toxicities are usually moderate and manageable. However, some adverse events, if not early recognised, could be life-threatening. We report a patient with non-small cell lung cancer who received treatment with pembrolizumab and developed multiple immune-related adverse events both during and after completing treatment, including rash, pericarditis, colitis and myasthenia gravis.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos Imunológicos/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Idoso , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos Imunológicos/administração & dosagem , Antineoplásicos Imunológicos/uso terapêutico , Colite/induzido quimicamente , Colite/tratamento farmacológico , Exantema/induzido quimicamente , Exantema/tratamento farmacológico , Feminino , Humanos , Neoplasias Pulmonares/patologia , Miastenia Gravis/induzido quimicamente , Miastenia Gravis/tratamento farmacológico , Pericardite/induzido quimicamente , Pericardite/tratamento farmacológico , Plasmaferese/métodos , Resultado do Tratamento
8.
Autoimmun Rev ; 18(6): 621-626, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30959210

RESUMO

Recurrent pericarditis is a frequent and troublesome complication of acute pericarditis. Aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine are the mainstay of therapy but few data is available on second-line treatment. We retrospectively analyzed 13 patients, 7 females (54%), median age 40 years, with a median of 4 (IQR 1-6) recurrences per patient despite a well conducted first-line treatment and a median follow-up of 59 months (IQR 38-70). Ten patients received corticosteroids as second-line therapy; 6 out of 10 responded to this therapy while 4 needed the addition of azathioprine. Three other patients received an immunosuppressive agent as second-line therapy (azathioprine, methotrexate, mycophenolate mofetyl). Overall, the mean frequency per month (± SD) of pericarditis recurrences was 0.69 (± 0.40) with aspirin/NSAIDs and colchicine, 0.22 (± 0.34) with corticosteroids alone and 0.01 (± 0.04) with immunosuppressive agents (p < 10-4). Immunosuppressive agents including azathioprine, methotrexate and mycophenolate mofetyl seem efficacious and well tolerated in patients with idiopathic recurrent pericarditis unresponsive to corticosteroids, corticosteroids-dependent or when corticosteroids side effects are judged unacceptable.


Assuntos
Corticosteroides/uso terapêutico , Imunossupressores/uso terapêutico , Pericardite/tratamento farmacológico , Adulto , Feminino , Humanos , Recidiva , Estudos Retrospectivos
9.
Autoimmun Rev ; 18(6): 627-631, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30959216

RESUMO

BACKGROUND: Approximately 5% of idiopathic recurrent pericarditis (IRP) patients are refractory or intolerant to NSAIDs, Colchicine and corticosteroids. The empiric treatment approach for these patients includes immunosuppression with Azathioprine (AZA) or immunomodulation with intravenous human immunoglobulin (IVIG). We assessed the efficacy and safety of long-term Anakinra treatment in refractory IRP patients after failure of prior immunosuppressive therapy and/or failure of IVIG. METHODS: Clinical data of seven IRP patients were retrospectively analyzed. Treatment efficacy was determined by decrease of IRP recurrence and by the ability to withdraw or taper corticosteroids without a relapse. Safety was assessed by the occurrence of adverse events. RESULTS: 7 IRP patients (4 male, median age 41) with a median disease duration of 4 years (range: 1.25-9 years) were treated with Anakinra (median treatment duration: 20 months). All patients were resistant or intolerant to NSAIDs, Prednisone, Colchicine and at least one immunosuppressive or immunomodulatory drug such as AZA, Methotrexate, Plaquenil, or IVIG. The median number of recurrences before Anakinra was 6 (range: 4-7) and all patients were corticosteroid-dependent and had steroid-related side effects. After initiation of Anakinra, none of the patients had IRP relapse. Prednisone was tapered down to 5 mg/day or less in all patients. Four patients discontinued prednisone altogether. No significant adverse effects have occurred as a result of Anakinra treatment and all patients continued treatment after the study period. CONCLUSION: Long-term Anakinra is a rapid-acting, efficient and safe steroid sparing agent even for patients with IRP refractory to previous immunosuppressive and/or immunomodulatory agents.


Assuntos
Antirreumáticos/uso terapêutico , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Pericardite/tratamento farmacológico , Adulto , Feminino , Humanos , Masculino , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
11.
BMJ Case Rep ; 12(4)2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30948415

RESUMO

A 54-year-old woman was referred to our centre for the third recurrence of colchicine-intolerant, corticosteroid dependent iatrogenic post-traumatic pericarditis after pacemaker placement 3 months prior to the first episode. The initial episode and each recurrence were associated with a pericardial effusion requiring drainage. Evaluation for pericardial infection, malignancy, autoimmune disease and pacemaker lead perforation was negative. After fourth recurrence and fifth pericardial drainage in 3 months, a trial of anakinra (interleukin-1 inhibitor), in addition to swift symptom resolution successfully prevented subsequent symptomatic and echocardiographic recurrence. Corticosteroids were tapered and eventually discontinued. At 4-month follow-up, the patient continues to be on daily anakinra 100 mg subcutaneous (SQ) daily without adverse effects.


Assuntos
Antirreumáticos/administração & dosagem , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Proteína Antagonista do Receptor de Interleucina 1/administração & dosagem , Marca-Passo Artificial/efeitos adversos , Pericardite/tratamento farmacológico , Corticosteroides/uso terapêutico , Colchicina/efeitos adversos , Feminino , Humanos , Doença Iatrogênica , Pessoa de Meia-Idade , Pericardite/etiologia , Recidiva
12.
Cardiol Young ; 29(4): 549-551, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30931868

RESUMO

Conventional algorithm for treatment of pericarditis and prevention of recurrences consists of non-steroid anti-inflammatory drugs and/or colchicine, followed by corticosteroids in resistant patients. Anakinra has emerged as a promising and safe treatment modality for steroid-dependent idiopathic recurrent pericarditis. However, the efficacy and safety of canakinumab, another anti-interleukin-1 agent, has not been assessed up to date. Herein, we present development of an anaphylactic reaction due to anakinra and a successful subsequent treatment with canakinumab for the first time in the literature.


Assuntos
Anafilaxia/induzido quimicamente , Anticorpos Monoclonais/uso terapêutico , Proteína Antagonista do Receptor de Interleucina 1/efeitos adversos , Pericardite/tratamento farmacológico , Anticorpos Monoclonais Humanizados , Criança , Ecocardiografia , Humanos , Injeções Subcutâneas , Masculino , Recidiva , Prevenção Secundária , Esteroides/uso terapêutico , Resultado do Tratamento
13.
BMC Infect Dis ; 19(1): 40, 2019 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-30630424

RESUMO

BACKGROUND: Acute pericarditis may occur frequently after viral infections. To our knowledge, influenza B virus infection complicated by pericarditis without myocardial involvement has never been reported. We report the first case of life-threatening pericarditis caused by influenza B virus infection. CASE PRESENTATION: A 48-years-old woman with trisomy 21 and ostium primum atrial septal defect was transferred from Cardiology to our Internal Medicine Department for severe pericardial effusion unresponsive to ibuprofen and colchicine. Based on the recent patient history of flu-like syndrome, and presence of pleuro-pericardial effusion, a viral etiology was suspected. Laboratory evaluation and molecular assay of tracheal aspirate identified influenza B virus. Therefore, the ongoing metilprednisolone and colchicine therapy was implemented with oseltamivir with progressive patient improvement and no evidence of pericardial effusion recurrence during follow-up. CONCLUSIONS: Especially in autumn and winter periods, clinicians should include Influenza B virus infection on differential diagnosis of pericarditis with large pericardial effusion.


Assuntos
Antivirais/uso terapêutico , Influenza Humana/complicações , Influenza Humana/tratamento farmacológico , Pericardite/tratamento farmacológico , Pericardite/virologia , Feminino , Humanos , Ibuprofeno/uso terapêutico , Vírus da Influenza B/patogenicidade , Influenza Humana/virologia , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Oseltamivir/uso terapêutico , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/virologia , Pericardite/diagnóstico
14.
Intern Med ; 58(8): 1119-1122, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30626813

RESUMO

IgG4-related diseases (IgG4-RDs) have recently been reported in many organs other than the salivary, pancreatic and hepatobiliary systems. A 64-year-old woman was referred to our department for her abdominal fullness and cardiomegaly on chest X-ray. After draining the pericardial fluid, her symptom promptly diminished, and pericardial friction rubbing became clearly audible. Elevated serum levels of IgG and IgG4 and ureteral wall thickening on computed tomography suggested IgG4-RD. After the initiation of oral corticosteroid therapy, the pericardial effusion was resolved, and she has been in a steady-state condition for the past two years.


Assuntos
Corticosteroides/uso terapêutico , Imunoglobulina G/efeitos adversos , Imunoglobulina G/sangue , Derrame Pericárdico/tratamento farmacológico , Pericardite/diagnóstico , Pericardite/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Pericardite/etiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
15.
Rev Esp Cardiol (Engl Ed) ; 72(9): 709-716, 2019 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30683494

RESUMO

INTRODUCTION AND OBJECTIVES: There is a paucity of information about the real benefit of colchicine administration in the first episode of acute idiopathic pericarditis (AIP). The main objective of the present study was to assess the real efficacy of colchicine in patients with AIP who did not receive corticosteroids. METHODS: Randomized multicenter open-label study. Patients with a first episode of AIP (not secondary to cardiac injury or connective tissue disease) were randomized into 2 groups: group A received conventional anti-inflammatory treatment plus colchicine for 3 months, and group B received conventional anti-inflammatory treatment only. None of the patients received corticosteroids. The primary endpoint was the appearance of recurrent episodes of pericarditis. The secondary endpoint was the time to first recurrence. Follow-up was extended to 24 months. RESULTS: A total of 110 patients (83.6% men, age 44±18.3 years) were randomized to group A (n=59) and group B (n=51). No differences were found in baseline demographics or in the clinical features of the index episode or in the type of anti-inflammatory treatment administered in both groups. The follow-up was completed by 102 patients (92.7%). No differences were found in the rate of recurrent pericarditis between groups (12 patients [10.9%]; group A vs group B, 13.5% vs 7.8%; P=.34). The time to first recurrence (group A vs group B, 9.6±9.0 vs 8.3±10.5 months; P=.80) did not differ between groups. CONCLUSIONS: Among patients with a first episode of AIP who had not received corticosteroids, the addition of colchicine to conventional anti-inflammatory treatment does not seem to reduce the recurrence rate. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrialsregister.eu. Identifier: EudraCT 2009-011258-16.


Assuntos
Colchicina/administração & dosagem , Pericardite/tratamento farmacológico , Doença Aguda , Adulto , Idoso , Relação Dose-Resposta a Droga , Ecocardiografia , Feminino , Seguimentos , Supressores da Gota/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Pericardite/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
16.
Rinsho Shinkeigaku ; 59(1): 21-26, 2019 Jan 30.
Artigo em Japonês | MEDLINE | ID: mdl-30606993

RESUMO

A 69-year-old man was admitted with neck muscle weakness, symmetric proximal muscle weakness, skin rash and elevated serum creatine kinase levels. Muscle biopsy showed perifascicular necrosis and perimysial alkaline phosphatase activity. Chest CT revealed interstitial lung disease and colorectal cancer was diagnosed on colonoscopy. He was serologically positive for anti-EJ antibody, leading to the diagnosis of antisynthetase syndrome (ASS). After laparoscopic low anterior resection of the rectum, he received intravenous methylprednisolone (1,000 mg/d for 3 days) followed by oral prednisolone (50 mg/d). Although his muscle weakness improved after corticosteroid therapy, he developed pericardial effusion with resultant asymptomatic hypotension and arrhythmia possibly due to pericarditis. Corticosteroid monotherapy was insufficient to control the disease, and, we decided to use oral cyclosporin concurrently. After this combined therapy started, pericardial effusion and arrhythmia were improved. We should keep in mind that pericarditis can occur in patients with anti-EJ antibody-positive ASS, and early combined therapy with corticosteroid and immunosuppressive drugs for ASS may improve the patient's prognosis.


Assuntos
Autoanticorpos/sangue , Glicina-tRNA Ligase/imunologia , Miosite/complicações , Miosite/imunologia , Pericardite/etiologia , Idoso , Biomarcadores/sangue , Ciclosporina/administração & dosagem , Progressão da Doença , Humanos , Masculino , Metilprednisolona/administração & dosagem , Miosite/diagnóstico , Miosite/tratamento farmacológico , Pericardite/tratamento farmacológico , Prednisolona/administração & dosagem , Pulsoterapia , Neoplasias Retais/complicações , Neoplasias Retais/cirurgia , Resultado do Tratamento
17.
Cardiol Young ; 29(2): 241-243, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30511600

RESUMO

In approximately 5% of patients with idiopathic recurrent pericarditis, the disease usually follows a chronic relapsing course, and children can develop dependence and side effects of prolonged high-dose corticosteroid regimens. In this setting anakinra, a recombinant human interleukin-1 competitive receptor antagonist that blocks the biologic effects of interleukin-1, thereby reducing systemic inflammatory responses, appears to be one of the most promising strategies. We report an adolescent with steroid-dependent idiopathic recurrent pericarditis that was successfully treated with anakinra, highlighting that this therapeutic option seems to be an effective, rapidly acting, steroid-sparing, and relatively safe agent for the treatment of this entity in children.


Assuntos
Proteína Antagonista do Receptor de Interleucina 1/administração & dosagem , Pericardite/tratamento farmacológico , Prednisona/administração & dosagem , Adolescente , Antirreumáticos/administração & dosagem , Doença Crônica , Quimioterapia Combinada , Glucocorticoides/administração & dosagem , Humanos , Imagem Cinética por Ressonância Magnética , Masculino , Pericardite/diagnóstico , Recidiva
19.
Ann Thorac Surg ; 107(1): e27-e29, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29932888

RESUMO

A 58-year-old man presented with tamponade and underwent an emergency pericardiocentesis. We made the diagnosis of methicillin-resistant Staphylococcus aureus pericarditis based on culture results and treated the patient with pericardial drainage and antibiotics as the first-line therapy. After temporary relief, reaccumulation of effusion developed. We successfully created a pericardial window using thoracotomy, and the patient's postoperative course was uneventful. Methicillin-resistant Staphylococcus aureus pericarditis is an extremely rare and life-threatening illness. No consensus exists concerning the ideal surgical intervention. Creating a pericardial window using thoracotomy can be an effective definitive therapy for methicillin-resistant Staphylococcus aureus pericarditis, especially for patients with significant pericardial adhesions.


Assuntos
Tamponamento Cardíaco/etiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Técnicas de Janela Pericárdica , Pericardite/cirurgia , Infecções Estafilocócicas/cirurgia , Antibacterianos/uso terapêutico , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/cirurgia , Terapia Combinada , Quimioterapia Combinada , Ecocardiografia , Emergências , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Líquido Pericárdico/microbiologia , Pericardiocentese , Pericardite/complicações , Pericardite/tratamento farmacológico , Pericardite/microbiologia , Diálise Renal , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Tomografia Computadorizada por Raios X , Dispositivos de Acesso Vascular/efeitos adversos
20.
Am J Ther ; 26(4): e485-e486, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29659374

RESUMO

CLINICAL FEATURES: Cardiotoxicity is a rare but serious side effect of clozapine. We present a case of a psychiatric patient on chronic clozapine 75 mg daily, who presented with congestive heart failure secondary to the cardiotoxic effects of the psychiatric medication. THERAPEUTIC CHALLENGE: Conventional heart failure treatment failed to improve symptoms. SOLUTION: A course of 40 mg of intravenous immunoglobulin and 125 mg of steroids was implemented, after which the patient made a full recovery. We hope to raise awareness of concurrent clozapine-induced pericarditis and myocarditis and propose a role of intravenous immunoglobulin and steroids in the treatment of drug-induced cardiomyopathy.


Assuntos
Clozapina/efeitos adversos , Imunoglobulinas Intravenosas/uso terapêutico , Metilprednisolona/uso terapêutico , Miocardite/tratamento farmacológico , Pericardite/tratamento farmacológico , Adulto , Biópsia , Cardiotoxicidade/diagnóstico , Cardiotoxicidade/tratamento farmacológico , Cardiotoxicidade/etiologia , Quimioterapia Combinada , Eletrocardiografia , Humanos , Masculino , Miocardite/induzido quimicamente , Miocardite/diagnóstico , Miocárdio/patologia , Pericardite/induzido quimicamente , Pericardite/diagnóstico , Pericárdio/efeitos dos fármacos , Pericárdio/patologia , Transtornos Psicóticos/tratamento farmacológico , Resultado do Tratamento
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