Recurrant Pericarditis

I am a 37 yr old male battling "recurrent pericarditis" constantly for 18 months.I had an emergent pericardial window performed 07/14/01.3 days after surgery I developed what has been diagnosed as pericarditis or Dresslers Syndrome.Prior to surgery I had same symptoms on 2 seperate occasions almost a year apart.Each episode lasted approx 10 days.Both episodes occured in March.Symptoms were chest pain ,extreme pain in shoulder&spine,shortness of breathe,unable to bend over or lay on back.Pericardits wasn't diagnosed until surgery. My treatment has been varying amounts of prednisone for 18 months betweet 40 & 15 mgs.The pattern is always when I wean down to 15mgs I develop a pleural effusion.Sed rate is good & echo normal.Blood test in hopstial ruled out lupus,lymes,hepatitis,cancer,tumor,fungal/bacterial,& TB.My rheumatologist also treating w/Cochicine & Imuran without positive results.I think I need a comprehensive reevaluation of my cindition but am unsure of the best facility to use.If I had pericarditis before surgery & still have it what other causes could there be for the inflammation of pericardium & pleural lining.My rheumatologust is suggesting Methetrexate to decrease inflammation. I feel my doctors should be focusing more on the cause of the inflammation.
Sincerely
Kevin

[CCF-M.D.-KE]

Dear Kevin,

Sorry to hear about your episodes of recurrent pericarditis. The treatment you  describe receiving for pericarditis is the standard of care. Unfortunately, pericarditis is a disorder that can recur inspite of excellent acute responses to medications. The cause of recurrent pericarditis, such as you describe is unknown, but it is felt to an autoimmune process.  Many of the drugs which have been acutely successful in your case, suppress the immune system.  I think your doctors have done a great job with such a difficult disease.

However, you may want to consider being evaluated at a large university based medical center for further evaluation. If the Cleveland Clinic is an option for you, visit our website at www.ccf.org or call for an appointment at 1-800-CCF-CARE. If you are interested Dr. Asher  (Cardiology) is an expert in this area.



Thanks for your question,


CCF-MD-KE