Pericardial tamponade complicating rheumatoid arthritis: a case report

BACKGROUND: Cardiovascular involvement in rheumatoid arthritis (RA) is increasingly observed and may be associated with the severity of rheumatoid arthritis. It is dominated by heart ischemic diseases related to atherosclerosis. Specific rheumatoid heart disease is commonly asymptomatic and found at autopsy or by echocardiography. Pericarditis is the commonest cardiac complication of RA. It is rarely clinically apparent and pericardial tamponade is exceptional. CASE REPORT: Herein, we report an unusual case of a 53-year-old female patient with a six-year history of seropositive and erosive rheumatoid arthritis who had developed a pericarditis complicated with tamponade resolved by pericardiocenthesis and high dose systemic steroids. Histopathology showed chronic inflammation and fibrosis. Under 1mg/day of colchicine, there were no recurrences at 10 months. CONCLUSION: Pericarditis is uncommon in rheumatoid arthritis. Forms with constriction or tamponade may have a fatal outcome. Pericardectomy usually recommended in constrictive forms, is sometimes indicated for tamponade. Some observations and randomised studies of idiopathic pericarditis suggest that colchicine may be interesting for the treatment and prevention of recurrences of rheumatoid arthritis-associated pericarditis.