Septic Rheumatoid Pericarditis Complicating Felty's Syndrome

✍ Scribed by Lee Shapiro; Robert B. Buckingham

• Publisher: John Wiley and Sons
• Year: 1981
• Tongue: English
• Weight: 271 KB
• Volume: 24
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780241118

✦ Synopsis

Evidence of pericarditis is commonly found at autopsy in subjects with classic rheumatoid arthritis, with a reported frequency as high as 30 to 50% (1,2). Pericarditis is much less common as a clinical entity, but, when it occurs, it may present dramatically with chest pain and tamponade (3,4).

Rheumatoid pleuritis is also a well recognized extraarticular manifestation, and chronic pleural effusions are often complicated by infection (5). In contrast, bacterial pericarditis has not been described as a significant complication of rheumatoid pericardial disease.

Here we report a patient with classic rheumatoid arthritis and Felty 's syndrome who developed bacterial pericarditis and tamponade.

Case Report. A 58-year-old white man was admitted to the Oakland (Pittsburgh) Veterans Administration Medical Center (VAMC) in November 1980 with a 2-day history of progressive dyspnea, substernal pain, and fever. He had a 30-year history of classic rheumatoid arthritis with erosive polyarthritis demonstrated on roentgenograms, multiple rheumatoid nodules, and rheumatoid factor in a titer as high as 1:5,120. In the past, he had been treated with salicy-From the