Why the study?
Recurrence of pericarditis is an important complication of acute pericarditis, motivating an analysis of how aetiology, clinical findings, and treatment influence outcomes.
Does the use of corticosteroids versus NSAIDs alone affect the risk of recurrence in pediatric idiopathic and viral pericarditis, and can colchicine substitute corticosteroids for recurrences?
Does the use of corticosteroids versus NSAIDs alone affect the risk of recurrence in pediatric idiopathic and viral pericarditis, and can colchicine substitute corticosteroids for recurrences?
Corticosteroid use in pediatric acute pericarditis is associated with a significantly higher risk of recurrence compared to NSAIDs, supporting the use of NSAIDs and colchicine as preferred therapies.
CS use may raise further relapses in first pediatric ROP; leaves open prospective trials of colchicine plus NSAID.
Background and Objectives: Recurrence of pericarditis (ROP) is an important complication of the acute pericarditis. The aim of this study was to analyse the influence of aetiology, clinical findings and treatment on the outcome of acute pericarditis. Methods: Data were retrospectively collected from medical records of patients treated from 2011 to 2019 at a tertiary referent heart paediatric center. Results: Our investigation included 56 children with idiopathic and viral pericarditis. Relapse was registered in 8/56 patients, 2/29 (7.41%) treated with nonsteroidal anti-inflammatory drugs (NSAID) and 6/27 (28.57%) treated with corticosteroids (CS) and NSAID. Independent risk factors for ROP were viral pericarditis (p = 0.01, OR 31.46), lack of myocardial affection (p = 0.03, OR 29.15), CS use (p = 0.02, OR 29.02) and ESR ≥ 50 mm/h (p = 0.03, OR 25.23). In 4/8 patients the first recurrence was treated with NSAID and colchicine, while treatment of 4/8 patients included CS. Children with ROP treated with CS had higher median number of recurrence (5, IQR: 2–15) than those treated with colchicine (0, IQR: 0–0.75). Conclusions: Independent risk factors for recurrence are CS treatment, viral aetiology, pericarditis only and ESR ≥ 50 mm/h. Acute pericarditis should be treated with NSAID. Colchicine and NSAID might be recommended in children with the first ROP.
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Vukomanović et al. (2019) studied this question.
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