This review outlines the pharmacological management of acute and recurrent pericarditis in pediatric patients, highlighting NSAIDs as first-line therapy and anakinra for refractory cases.
Recurrent pediatric idiopathic pericarditis management remains challenging; leaves open optimal steroid-sparing strategies.
Chest pain in children and adolescents is rarely associated with an underlying heart disease. How-ever, when it does occur, pericarditis is the most common cause. Most cases are of unknown origin (idiopathic) and mild. Up to 15-35% of paediatric patients with idiopathic pericarditis experience a recurrence during their lives and clinical management in these cases may be challenging. NSAIDs are the first-choice drugs for the treatment of acute idiopathic pericarditis. Corticosteroids should be reserved for refractory pericarditis and autoimmune or autoinflammatory disorders with peri-cardial involvement. Colchicine plays a central role for the management of recurrent forms while anakinra has recently emerged as a remedy for colchicine-resistant and corticosteroid-dependent recurrent pericarditis.
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Paolera et al. (2021) studied this question.
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