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Graft-versus-host disease: a case report of a rare but reversible cause of constrictive pericarditis
- Source :
- European Heart Journal: Case Reports
- Publication Year :
- 2020
- Publisher :
- Oxford University Press, 2020.
-
Abstract
- Background Constrictive pericarditis (CP), although an uncommon cause of heart failure, requires specialist multidisciplinary input and multi-modality imaging to identify the underlying aetiology and treat potentially reversible causes. Case summary We report the case of a 74-year-old gentleman referred for assessment of progressive exertional dyspnoea and peripheral oedema, 30 months following treatment of acute myeloid leukaemia with high-dose chemotherapy and allogeneic stem cell transplantation. Clinical examination and cardiac imaging revealed a small pericardial effusion and pericardial thickening with constrictive physiology; however, no aetiology was identified despite diagnostic pericardiocentesis. The patient required recurrent hospital admissions for intravenous diuresis, therefore, following multidisciplinary discussions, surgical partial pericardectomy was performed. Histology suggested graft-vs.-host disease (GvHD) and post-operatively, the patient improved clinically. Following immunomodulatory therapy with ruxolitinib for both pericardial and pulmonary GvHD, his functional status improved further with no subsequent hospital admissions. Discussion Although pericardial disease in cancer patients is common, CP is unusual. Determining the underlying aetiology is important for subsequent management, and here, we describe the use of multi-modality imaging to diagnose a rare cause, GvHD, which responded to surgical treatment and immunomodulatory therapy.
- Subjects :
- Constrictive pericarditis
medicine.medical_specialty
medicine.medical_treatment
Peripheral edema
Heart failure
030204 cardiovascular system & hematology
Pericardial effusion
Graft-vs.-host disease
03 medical and health sciences
0302 clinical medicine
Case report
medicine
Pericardiectomy
business.industry
medicine.disease
Surgery
Allogeneic stem cell transplantation
Transplantation
Cardio-oncology
Graft-versus-host disease
Pericardiocentesis
030220 oncology & carcinogenesis
Other
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- ISSN :
- 25142119
- Volume :
- 4
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- European Heart Journal: Case Reports
- Accession number :
- edsair.doi.dedup.....c10f391940ab4a8b2f0ccbaca258ea29