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Rare disease
CASE REPORT
Liver chemistry abnormalities and leg oedema in rheumatoid arthritis
  1. Eva Marianne van Soest1,2,
  2. Anho Liem3,
  3. Jende van Zeben2
  1. 1 Rheumatology, Erasmus MC, Rotterdam, The Netherlands
  2. 2 Rheumatology, Sint Franciscus Vlietland Groep, Rotterdam, The Netherlands
  3. 3 Cardiology, Sint Franciscus Vlietland Groep, Rotterdam, The Netherlands
  1. Correspondence to Dr Eva Marianne van Soest, e.vansoest{at}erasmusmc.nl

Summary

A 66-year-old man with seronegative, erosive rheumatoid arthritis for 12 years presented with malaise, elevated alkaline phosphatase and gamma-glutamyl transferase, and leg oedema. He subsequently developed ascites. No liver pathology was found, but cardiac analysis including right heart catheterisation revealed constrictive pericarditis. Rheumatoid constrictive pericarditis is a rare condition, but, despite current effective treatment for rheumatoid arthritis, still occurs. Diagnostic delay is frequent. Although mortality of the intervention is high, pericardiectomy is needed for most patients.

  • pericardial disease
  • rheumatoid arthritis

https://doi.org/10.1136/bcr-2017-223206

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    Footnotes

    • Contributors EMvS: conception and draft of the report. AL: provided patient data, critical revision of the manuscript, final approval of the manuscript. JvZ: provided patient data, acquired patient consent for publication, critical revision of the manuscript, final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

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