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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Al-ani, Mohammad Weber, Michelle Winchester, David Kosboth, Matthew |
| Description | Author Affiliation: Al-Ani M ( Department of Internal Medicine, University of Florida, Gainesville, Florida, USA.); Weber M ( Department of Pathology, Malcom Randall VAMC, NF/SGVHS, Gainesville, Florida, USA.); Winchester D ( Department of Internal Medicine - Division of Cardiology, University of Florida, Gainesville, Florida, USA.); Kosboth M ( Department of Internal Medicine - Division of Rheumatology, Malcom Randall VAMC, NF/SGVHS, Gainesville, Florida, USA.) |
| Abstract | A 65-year-old man presented with long-standing rheumatoid arthritis (RA), severe fatigue and mild arthritis of metacarpophalaneal joints. Physical examination revealed S3, II/IV decrescendo diastolic murmur and 2+ LL oedema. Anticyclic citrullinated peptide antibodies were >250â units. Echocardiogram showed an 8â cm pericardial mass with no atrial or ventricular collapse and mild to moderate aortic regurgitation. Cardiac MRI defined the mass as a heterogeneous entity attached to the right, anterior and inferior heart borders, with compression on right cardiac structures and the left ventricle. CT-guided biopsy demonstrated fibrinous material without granulomas or infection. Fatigue did not improve on immunosuppression with low-dose prednisone and leflunamide. Cardiac tamponade was confirmed by heart catheterisation and the mass was surgically excised with partial pericardiectomy. The patient had a dramatic improvement and, 4â years later, he remains asymptomatic cardiac wise. This case highlights the clinical significance of pericardial disease in RA and its response to therapy. |
| Volume Number | 2015 |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Arthritis, Rheumatoid Complications Cardiac Tamponade Etiology Heart Neoplasms Pericardium Pathology Aged Antibodies Blood Aortic Valve Insufficiency Surgery Echocardiography Heart Heart Murmurs Humans Male Pericardial Effusion Pericardiectomy Pericarditis Case Reports Journal Article Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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