Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-26T20:43:35.036Z Has data issue: false hasContentIssue false

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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