Rheumatoid pericarditis. Rapid deterioration with evidence of local vasculitis
S. Butman, L. R. Espinoza, J. Del Carpio and C. K. Osterland
In a patient with classical rheumatoid arthritis and pericardial
involvement, accelerated restriction of cardiac filling resulting from
pericardial constriction developed. Pericardiectomy was necessary to
relieve this condition. Examination of the synovial and pericardial fluid
showed noteworthy decreases in total hemolytic complement (CH50) and C3
levels, while these were normal in the serum. Immunofluorescence staining
of the pericardium showed plasma cell infiltration and immune deposit
staining of pericardial vessels with IgG, IgM, IgA, or C3. These findings
suggest that immune complexes deposition plays an important role in the
pathogenesis of this condition.
