Pericardial involvement as an atypical manifestation of giant cell arteritis: report of a clinical case and literature review

• Published in: The American journal of the medical sciences Vol. 332; no. 4; p. 198
• Main Authors: Bablekos, George D, Michaelides, Stylianos A, Karachalios, George N, Nicolaou, Irene N, Batistatou, Anna K, Charalabopoulos, Konstantinos A
• Format: Journal Article
• Language: English
• Published: United States 01-10-2006
• Subjects: Adrenal Cortex Hormones - administration & dosage; Aged; Biopsy - methods; Diagnosis, Differential; Echocardiography - methods; Female; Giant Cell Arteritis - complications; Giant Cell Arteritis - diagnosis; Giant Cell Arteritis - diagnostic imaging; Giant Cell Arteritis - drug therapy; Giant Cell Arteritis - pathology; Humans; Pericardial Effusion - complications; Pericardial Effusion - diagnosis; Pericardial Effusion - diagnostic imaging; Pericardial Effusion - drug therapy; Pericardial Effusion - pathology; Temporal Arteries - diagnostic imaging; Temporal Arteries - pathology
• ISSN: 0002-9629
• DOI: 10.1097/00000441-200610000-00007

Pericardial effusion has been known to be a rare manifestation of giant cell arteritis. During the last six decades, only 24 cases have been cited in the literature. In this report, we describe the case of a patient presenting with nonspecific symptoms and development of pericardial effusion.
A 71-year-old woman was admitted to the hospital with low-grade fever, exertion breathlessness, atypical diffuse muscular pain, and weight loss over a period of about 5 weeks. Pericardial effusion and giant cell arteritis were diagnosed by echocardiography and left temporal artery biopsy, respectively. Treatment with corticosteroids resulted in remarkable improvement of symptoms and complete remission of pericardial effusion. One year after admission, the patient remained in a stable good condition, under low steroid maintenance dosage.
The diversity of clinical manifestations (such as pericardial effusion) in such a potentially severe disease should alert the physician to prompt diagnosis and treatment in view of impending irreparable vascular damages, even in cases in which the initial presentation is quite uncommon.