Pericarditis in Systemic Rheumatologic Diseases

Curr Cardiol Rep. 2020 Sep 10;22(11):142. doi: 10.1007/s11886-020-01415-w.


Purpose of review: We review the epidemiology, pathophysiology, and management of pericarditis most commonly complicating autoimmune and autoinflammatory conditions.

Recent findings: Typically, pericarditis occurs in the context of a systemic flare of the underlying disease but infrequently, it is the presenting manifestation requiring a high index of suspicion to unravel the indolent cause. Pericardial involvement in rheumatic diseases encompasses a clinical spectrum to include acute, recurrent and incessant pericarditis, constrictive pericarditis, asymptomatic pericardial effusion, and pericardial tamponade. Direct evidence on the pathophysiology of pericarditis in the context of rheumatic diseases is scant. It is theorized that immune perturbations within pericardial tissue result from the underlying central immunopathology of the respective autoimmune or autoinflammatory disease. Pericarditis management depends on acuity, the underlying cause and epidemiological features such as patient's immune status and geographic prevalence of infections such as tuberculosis. Immunosuppressive medications including biologics such as interleukin 1 blockers emerge as possible steroid sparing agents for pericarditis treatment.

Keywords: Autoimmune; Autoinflammatory; Pathophysiology; Pericarditis; Rheumatic; Treatment.

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid*
  • Cardiac Tamponade* / epidemiology
  • Cardiac Tamponade* / etiology
  • Humans
  • Pericardial Effusion* / epidemiology
  • Pericardial Effusion* / etiology
  • Pericarditis* / drug therapy
  • Pericarditis* / epidemiology
  • Pericarditis, Constrictive* / diagnosis
  • Pericarditis, Constrictive* / drug therapy
  • Pericarditis, Constrictive* / epidemiology