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

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.

• Authors: Quentin Gomes de Pinho, Aurélie Daumas, Audrey Benyamine, Julien Bertolino, Pascal Rossi, Nicolas Schleinitz, Jean-Robert Harlé, Pierre André Jarrot, Gilles Kaplanski, Julie Berbis, Brigitte Granel
• Journal: Rheumatology international (Rheumatol Int) Vol. 42 Issue 11 Pg. 2013-2018 (11 2022) ISSN: 1437-160X [Electronic] Germany
• PMID: 35525874 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Biomarkers
• Hemoglobins

Topics

• Biomarkers
• Giant Cell Arteritis (complications, diagnostic imaging)
• Hemoglobins
• Humans
• Pericardial Effusion (diagnostic imaging, etiology)
• Pericarditis (complications)
• Polymyalgia Rheumatica (diagnosis)
• Retrospective Studies