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Pericardial effusion in giant cell arteritis is associated with increased inflammatory markers: a retrospective cohort study. | LitMetric

AI Article Synopsis

  • Giant cell arteritis (GCA) primarily affects people over 50 years old, and while cardiac involvement is rare, this study focuses on patients with pericardial effusion at diagnosis.
  • Out of 250 GCA patients, 9.2% had pericardial effusion, showing similarities in age and gender but notable differences in symptoms, such as higher weight loss and specific blood marker levels.
  • The study concludes that GCA can cause unexplained pericardial effusion in older adults, but this complication is generally benign, emphasizing the importance of recognizing related symptoms for prompt diagnosis.

Article Abstract

Objective: Giant cell arteritis (GCA) is the most frequent vasculitis affecting adults aged > 50 years. Cardiac involvement in GCA is considered rare, and only a few cases of pericarditis have been reported. The aim of this study was to determine the characteristics and prognosis of GCA patients suffering from pericardial involvement at diagnosis.

Methods: We conducted a single-centre, retrospective chart review of patients with GCA in internal medicine departments (from 2000 to 2020). Patients were identified through a centralized hospital database. We retrospectively collected demographic, clinicobiological, histological, imaging, treatment and outcome data. Patients with pericardial effusion, defined as an effusion visible on the CT-scan performed at GCA diagnosis were compared to those without pericardial involvement.

Results: Among the 250 patients with GCA, 23 patients (9.2%) had pericardial effusion on CT-scan. The comparison between the groups revealed similar distribution of age, gender, cranial symptoms and ocular ischaemic complications. Patients with pericardial effusion had a higher frequency of weight loss. They also had lower haemoglobin levels and higher platelet levels (p = 0.006 and p = 0.002, respectively), and they more frequently had positive temporal artery biopsy. There were no differences concerning the treatment, relapses, follow-up duration or deaths.

Conclusions: This case series sheds light on GCA as a cause of unexplained pericardial effusion or symptomatic pericarditis among adults aged > 50 years and elevated inflammatory biological markers. Fortunately, pericardial involvement is a benign GCA manifestation. In that context, the search for constitutional symptoms, cranial symptoms and associated signs of polymyalgia rheumatica is crucial for rapidly guiding GCA diagnosis.

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http://dx.doi.org/10.1007/s00296-022-05137-wDOI Listing

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