Effusive-constrictive pericarditis in a patient with end-stage renal disease (RCD code: VI-4D.1)

Abstract

Renal disease, especially end-stage renal disease, is associated with possible pericardial involvement. We report the case of a 51-year-old patient with a history of end-stage-renal disease, currently receiving chronic haemodialysis. The patient was admitted to the ward due decreased exercise tolerance and elevation of inflammatory markers. Features of active exudative-constrictive pericarditis were detected upon imaging studies (echocardiography, computed tomography). The haemodialysis regimen was intensified and anti-inflammatory treatment was administered. In the follow-up examination, the patient presented with improved clinical status and echocardiography revealed a decreased amount of pericardial fluid with no pattern of constriction. The elevation of CRP and evidence of active pericardial inflammation upon contrast enhancement seen in CT may help to identify patients with potentially reversible forms of pericardial constriction. In this group of patients, in addition to intensification of dialysis, anti-inflammatory therapy should be considered to prevent the need for pericardiectomy.