Overview
Acute pleuropericarditis involves inflammation affecting both the pleura and pericardium, often presenting with chest pain, pericardial friction rub, and pleural effusion. The etiology can be idiopathic, post-cardiac injury, or post-infectious, with evidence suggesting an autoinflammatory rather than autoimmune mechanism 1.Diagnosis
Clinical presentation includes chest pain, dyspnea, and signs of pericardial and pleural involvement.
Electrocardiogram (ECG) may show nonspecific changes or pericarditis patterns.
Echocardiography is crucial for assessing pericardial effusion and cardiac function.
Serum markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are often elevated.
Serological analysis helps differentiate idiopathic from autoimmune causes 1.Management
First-line treatments: Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation control.
Adjunctive treatments: Corticosteroids may be considered in refractory cases or severe inflammation 1.
Monitoring: Regular echocardiograms to track pericardial effusion resolution.
Discontinuation of causative agents: If pleuropericarditis is linked to medication like dantrolene, discontinuation is essential 2.Special Populations
No specific guidance provided for pregnancy, pediatrics, or elderly patients in the given abstracts.
Comorbidities: Careful monitoring and management of underlying conditions that may trigger pleuropericarditis 1.Key Recommendations
Evaluate idiopathic pleuropericarditis patients for autoinflammatory mechanisms rather than autoimmune disease, considering serological markers 1 (Evidence: Moderate).
Monitor for recurrent attacks, as a majority of patients experience relapses within the follow-up period 1 (Evidence: Moderate).
Consider discontinuation of dantrolene in cases developing pleuropericardial reactions, given the potential association 2 (Evidence: Weak).References
1 Kaudewitz D, John L, Meis J, Frey N, Lorenz HM, Leuschner F et al.. Clinical and serological characterization of acute pleuropericarditis suggests an autoinflammatory pathogenesis and highlights risk factors for recurrent attacks. Clinical research in cardiology : official journal of the German Cardiac Society 2025. link
2 Petusevsky ML, Faling LJ, Rocklin RE, Snider GL, Merliss AD, Moses JM et al.. Pleuropericardial reaction to treatment with dantrolene. JAMA 1979. link