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Methotrexate in recurrent postpericardiotomy syndrome

Published online by Cambridge University Press:  18 April 2005

Nili Zucker
Affiliation:
Pediatric Cardiology Unit, Division of Pediatrics, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
Aviva Levitas
Affiliation:
Pediatric Cardiology Unit, Division of Pediatrics, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
Eli Zalzstein
Affiliation:
Pediatric Cardiology Unit, Division of Pediatrics, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel

Abstract

The postpericardiotomy syndrome occurs in up to one-third of children undergoing cardiac surgery. Its treatment includes anti-inflammatory agents, diuresis, and drainage of effusions. Administration of steroids can have a dramatic effect, but is limited by adverse effects. Usually the syndrome lasts weeks only, and persistence beyond six months is exceptional. We describe a rare case of chronic postpericardiotomy syndrome, with recurrent pericardial effusions and steroid dependency, that was treated successfully with a low weekly dose of methotrexate.

Type
Brief Report
Copyright
© 2003 Cambridge University Press

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References

Engle MA, Zabriskie JB, Senterfit LB, Gay WA Jr, O'Loughlin JE Jr, Ehlers KH. Viral illness and the postpericardiotomy syndrome. A prospective study in children. Circulation 1980; 62: 11511158.Google Scholar
Clapp SK. In: Garson A, Bricker JT, Fisher DJ, Neish SR (eds).> Postoperative inflammatory syndromes. Williams and Wilkins, Baltimore, MD, 1998, pp 18171821.
Maisch B, Berg PA, Kochsiek K. Clinical significance of immunopathological findings in patients with post-pericardiotomy syndrome. I. Relevance of antibody pattern. Clin Exp Immunol 1979; 38: 189197.Google Scholar
Wilson NJ, Webber SA, Patterson MWH, Sandor GGS, Tipple M, LeBlanc J. Double-blind placebo-controlled trial of corticosteroids in children with postpericardiotomy syndrome. Pediatr Cardiol 1994; 15: 6265.Google Scholar
Webber ST, Wilson NJ, Junker AK, et al. Postpericardiotomy syndrome: no evidence for a viral etiology. Cardiol Young 2001; 11: 6774.Google Scholar
De Scheerder I, Wulfrank D, Van Renterghem L. Association of anti-heart antibodies and circulating immune complexes in the post-pericardiotomy syndrome. Clin Exp Immunol 1984; 57: 423428.Google Scholar
Horneffer PJ, Miller RH, Pearson TA, Rykiel MF, Reitz BA, Gardner TJ. The effective treatment of postpericardiotomy syndrome after cardiac operations. A randomized placebo-controlled trial. J Thorac Cardiovasc Surg 1990; 100: 292296.Google Scholar
Engle MA, Zabriskie JB, Senterfit LB. Heart-reactive antibody, viral illness, and the postpericardiotomy syndrome. Trans Am Clin Climatol Assoc 1976; 87: 147160.Google Scholar
Guss S, Portnoy J. Methotrexte treatment of severe asthma in children. Pediatrics 1992; 89 (4 Pt 1): 635639.Google Scholar
Knobel B, Rosman P. Cholesterol pericarditis associated with rheumatoid arthritis [Hebrew]. Harefuah 2001; 140: 1012, 87.Google Scholar