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Recurrent pericarditis: current challenges and future prospects

Authors Dauphin C, Merlin E, Chalard A, Trésorier R, Lusson J, Soubrier M

Received 18 January 2016

Accepted for publication 5 May 2016

Published 18 July 2016 Volume 2016:7 Pages 99—108


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 4

Editor who approved publication: Dr Richard Kones

Claire Dauphin,1 Etienne Merlin,2 Aurélie Chalard,1 Romain Trésorier,1 Jean-René Lusson,1 Martin Soubrier3

1Department of Cardiology and Cardiovascular Diseases, 2Department of Pediatrics, 3Department of Rheumatology, Clermont-Ferrand Hospital, Clermont-Ferrand, France

Recurrent pericarditis, usually idiopathic, is difficult to treat. Previous etiological studies can eliminate potentially serious causes that require specific treatment. The pathophysiology of “idiopathic” pericarditis involves autoimmunity and autoinflammation in various degrees and is usually caused by a microbacteriological or postinjury trigger. It requires multidisciplinary care to provide individualized treatment to each patient: treatment escalation by increments, then weaning should be guided by clinical examination but also CRP and potential magnetic resonance imaging. The role of immunomodulators, especially anakinra, should be revisited. Their efficacy is remarkable, and they could be considered for second-line treatment, preferably with corticosteroids (at least among certain selected patients), especially after the failure of prolonged and high-dose standard therapy with aspirin/nonsteroidal anti-inflammatory drugs and colchicine.

Keywords: recurrent pericarditis, review, pathophysiology, individualized treatment, multidisciplinary care, treatment options

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