PERICARDITIS IN JUVENILE RHEUMATOID ARTHRITIS

Abstract

Pericarditis was diagnosed clinically in 20 of a series of 285 cases of juvenile rheumatoid arthritis (7%). Of 11 postmortem studies in patients with juvenile rheumatoid arthritis, pericarditis was found in 5 (45%). In a patient with juvenile rheumatoid arthritis pericarditis may occur at any age, and its occurrence is unrelated to sex or age of onset of arthritis. Pericarditis usually follows arthritis and is usually associated with fever, leukocytosis and an elevated erythrocyte sedimentation rate. A patient who develops pericarditis is also prone to develop a skin rash, lymphadenopathy, splenomegaly, pulmonary disease, and amyloid disease. The presence of pericarditis is unrelated to the severity of the arthritis but may be related to a more severe course because of its relation to amyloid. The pericarditis may be asymptomatic. The usual physical findings consist of friction rub, tachycardia and tachypnea. X-ray and electrocardiographic changes are frequently useful in its detection. The clinical course of pericarditis is usually short and benign. No cardiac residua were detected. There is no evidence for the necessity nor for the efficacy of adrenocortical steroids.