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Lessio S et al.  
Cyclosporin A in the treatment of idiopathic recurrent pericarditis: a case report

Journal of Clinical and Basic Cardiology 1999; 2 (1): 130-131

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Keywords: cyclosporinImmunsuppressivaPerikarditiscyclosporinimmunosuppressive agentspericarditis

The aetiology of idiopathic recurrent pericarditis is still unknown, but there is evidence of an immune-mediated pathogenesis. While there is general agreement on non-steroidal anti-inflammatory drugs as initial treatment for the disease, the use of steroids or immunosuppressive agents still remains controversial; these drugs are usually reserved for selected or resistant cases, before considering surgical management. We describe a 44 years old man who presented recurrent pericarditis and familial non-immune-mediated thrombocytopenia, who obtained a stable remission following a five months treatment with cyclosporin A. The drug was administered alone because of the patient?s poor tolerance for corticosteroids and the risk of myelosuppression related to cytotoxic immunosuppressive drugs. Before cyclosporin A therapy, he suffered three consecutive recurrences over a period of four months despite prolonged treatment with non-steroidal anti-inflammatory drugs and/or prednisone. In the two years following cyclosporin A discontinuation, the patient did not experience any further recurrence of the disease. In the patient described here, cyclosporin A alone appeared effective in preventing the recurrences of pericarditis. This evidence supports the hypothesis that idiopathic recurrent pericarditis may have an immune-mediated pathogenesis and suggests further study on the role of immunosuppressive agents in the management of the disease. J Clin Basic Cardiol 1999; 2: 130-1.
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