Key result
Triple anti-inflammatory therapy resolves autoimmune polyserositis within ~6 weeks in a young athlete.
Why the study?
Although musculoskeletal causes are the most frequent etiology of chest pain in athletes, rare and potentially life-threatening etiologies such as autoimmune polyserositis must also be considered.
Case Report (n=1)
This case underscores the necessity of thorough diagnostic evaluation for chest pain in young athletes to identify rare autoimmune etiologies such as polyserositis with acute pericarditis.
Autoimmune screening should not yet alter chest pain evaluation in athletes; leaves open whether MCTD is underrecognized in elite sports.
Background The evaluation of chest pain is a common reason for athletes to seek consultation at a sports medicine clinic. Musculoskeletal causes are by far most frequent; however, rare and potentially life-threatening etiologies must also be considered. Case summary A 22-year-old professional rugby player presented with pleuritic chest pain of two week’s duration. Physical examination was unremarkable except for reduced breath sounds at the left lung base. Laboratory testing demonstrated marked systemic inflammation with a C-reactive protein level of 237mg/l and mildly elevated high-sensitivity troponin T (21pg/mL). Transthoracic ultrasound identified a fibrinous left-sided pleural effusion and a mild circumferential pericardial effusion. Subsequent cardiac magnetic resonance imaging (CMRI) confirmed the diagnosis of acute pericarditis. Comprehensive rheumatological evaluation established an autoimmune etiology, consistent with a polyserositis secondary to mixed connective tissue disease (ANA 1:80.000, speckled pattern, anti-RNP positive). Anti-inflammatory therapy with ibuprofen, colchicine and a corticosteroid pulse were initiated, resulting in clinical improvement and gradual normalization of laboratory and sonographic imaging findings within 6 weeks. After three months of sports restriction, follow-up CMRI demonstrated significant pericardial late gadolinium enhancement but without evidence of active inflammation. A gradual return-to-exercise protocol was subsequently implemented. Anti-inflammatory medication was discontinued after six months. The athlete has since remained clinically stable under regular follow-up for one year. Discussion This case highlights the importance of thorough diagnostic evaluation of chest pain in young athletes, including consideration of autoimmune causes like polyserositis. Despite structured follow-up, uncertainty persists regarding recurrence risk and its significance for long-term athletic participation.
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Betz et al. (2026) conducted a case report in Polyserositis with acute pericarditis secondary to mixed connective tissue disease (n=1). Ibuprofen, colchicine, and a corticosteroid pulse was evaluated on Clinical improvement and normalization of laboratory and sonographic imaging findings. Anti-inflammatory therapy with ibuprofen, colchicine, and corticosteroids normalized laboratory and imaging findings within 6 weeks in a 22-year-old athlete with autoimmune polyserositis.
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