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Reminder of important clinical lesson
CASE REPORT
Tuberculous pericarditis treated with steroid in a dialysis patient
  1. Rie Aoyama1,
  2. Joji Ishikawa2,
  3. Kazumasa Harada2,
  4. Yayoi Tukada3
  1. 1Department of Cardiovascular Medicine, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
  2. 2Department of Cardiovascular Medicine, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
  3. 3Depatment of Cardiovascular Medicine, Nippon Medical School, Bunkyou-ku, Japan
  1. Correspondence to Dr Rie Aoyama, r-aoyama{at}nms.ac.jp

Summary

Mycobacterium tuberculosis has spread worldwide and its mortality rate had been very high. The prevention technology and antituberculosis (TB) chemotherapy has improved its prognosis. However, immunocompromised patients, such as those who had HIV infection, older age and on haemodialysis, are still at high risk of TB infection. TB pericarditis is a common cause of constrictive pericarditis and its mortality remains high. Early diagnosis and initiation of appropriate therapy are critical to improve mortality. Additionally, detection of an elevation in the adenosine deaminase level in pericardial effusion is reported to be useful. We report the case of an immunocompromised patient with TB pericarditis, and steroid therapy could prevent him from progressing to constrictive pericarditis. The adenosine deaminase value of pericardial effusion was so helpful that we could promptly make clinical and therapeutic decisions.

  • tb and other respiratory infections
  • heart failure

https://doi.org/10.1136/bcr-2017-220562

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    Footnotes

    • Contributors RA did the data collection, interpretation and drafting the article. JI and YT did the critical revision of the article. KH did the final approval of the version to be published.

    • Disclaimer I certify that neither this manuscript nor one with substantially similar content under my authorship has been published or is being considered for publication elsewhere (except as indicated in an attachment). I have access to any data upon which the manuscript is based and will provide such data upon request to the editors or their assignees. I agree to allow the corresponding author to correspond with the editorial office, to review the uncorrected proof copy of the manuscript and to make decisions regarding release of information in the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.