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Recurrent pericarditis in children: elevated cardiac autoantibodies

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Summary

Recurrent pericarditis is a rare disease in childhood. Nevertheless, it may represent a challenge to the clinician due to its resistance to anti-inflammatory treatment. The initial etiology often remains unclear; specific laboratory parameters predicting the frequency or severity of the recurrences are lacking. We report on four patients with recurrent pericarditis in whom antimyolemmal antibodies (AMLAs) were detected. A prolonged persistence of IgM-type AMLAs was found in three patients: two of them presented with acute inflammation as the initial event and one with 48 recurrences during 5.5 years. The fourth patient showed a fast conversion from IgM to IgG-type AMLAs after a less acute initial presentation and showed 4 mild recurrences during the 48-month follow-up.

Conclusion

We were able to detect AMLAs in four children with recurrent pericarditis. This finding may be attributed to an auto-immunological disease following a first, acute event. We propose the detection of AMLAs in all children with unexplained recurrent pericarditis. Pediatric patients with a persistence of IgM-type AMLAs may face frequent recurrences and should be monitored therefore more closely. In addition, medical treatment may be changed in these patients with a slower tapering of the dosage of steroidal and non-steroidal antiinflammatory drugs.

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Authors and Affiliations

  1. Department of Pediatric Cardiology, University Children’s Hospital, Lindwurmstr. 4, 80337, Munich, Germany

    Robert Dalla Pozza,  Simon Urschel,  Rainer Kozlik-Feldmann &  Heinrich Netz

  2. Department of Immunology, University Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany

    Dominik Hartl,  Susanne Bechtold &  Bernd Belohradsky

  3. Department of Cardiology, Phillips-University, Marburg, Germany

    Sabine Pankuweit

Authors
  1. Robert Dalla Pozza
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  2. Dominik Hartl
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  3. Susanne Bechtold
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  4. Simon Urschel
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  5. Rainer Kozlik-Feldmann
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  6. Sabine Pankuweit
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  7. Bernd Belohradsky
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  8. Heinrich Netz
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Correspondence to Robert Dalla Pozza.

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Dalla Pozza, R., Hartl, D., Bechtold, S. et al. Recurrent pericarditis in children: elevated cardiac autoantibodies. Clin Res Cardiol 96, 168–175 (2007). https://doi.org/10.1007/s00392-007-0471-6

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  • DOI: https://doi.org/10.1007/s00392-007-0471-6

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