Yeungnam Univ J Med.  2018 Dec;35(2):222-226. 10.12701/yujm.2018.35.2.222.

Colchicine for steroid-resistant recurrent pericarditis in a child

• Shin JH
• Lee DH
• Choi HJ

• KMID: 2433743
• DOI: http://doi.org/10.12701/yujm.2018.35.2.222

Abstract

Recurrent pericarditis is rare in children and is considered idiopathic in most cases. Its course is chronic, and preventing recurrences is important for the patient's quality of life. Although a treatment strategy in pediatric recurrent pericarditis has not yet been established, non-steroidal anti-inflammatory drugs (NSAIDs) are the most common treatment for management of this condition, followed by corticosteroids, colchicine, immunosuppressive agents, immunoglobulins, and interleukin-1β receptor antagonists (e.g. anakinra). Herein, we report a case of recurrent pericarditis with pericardial effusion in a 5-year-old child who presented with fever and epigastric pain. He responded poorly to NSAIDs and corticosteroid therapy, but was successfully treated with colchicine.

Keyword

Children; Colchicine; Recurrent pericarditis

MeSH Terms

Adrenal Cortex Hormones
Anti-Inflammatory Agents, Non-Steroidal
Child*
Child, Preschool
Colchicine*
Fever
Humans
Immunoglobulins
Immunosuppressive Agents
Pericardial Effusion
Pericarditis*
Quality of Life
Recurrence
Adrenal Cortex Hormones
Anti-Inflammatory Agents, Non-Steroidal
Colchicine
Immunoglobulins
Immunosuppressive Agents

Figure

• 

  Fig. 1. Chest radiograph and electrocardiography of the patient on admission day. (A) Chest radiograph showed cardiomegaly with a cardiac-thoracic ratio of 0.56. (B) Electrocardiography showed ST elevation was observed in leads II, III, aVF, and V4-V6.

• 

  Fig. 2. Imaging studies of the patients on the sixth hospital day. (A) Pericardial effusion approximately 10 mm on the posterior side of the left ventricle in parasternal long axis view of Echocardiogram. (B) Pericardial effusion approximately 8.3 mm on the right side and 8.5 mm on the left side of the heart in apical four chamber view of Echocardiogram. (C) Chest radiograph showed cardiomegaly with a cardiac-thoracic ratio of 0.69. (D) Electrocardiography showed normal ST segment and T wave flattening.

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