Pericarditis in Chronic Uremia and Its Sequels

Comty, Christina M.; Cohen, Simon; Shapiro, F.L.

doi:10.7326/0003-4819-75-2-173

Cited by 146 publications

(92 citation statements)

References 13 publications

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“…During the time of observation, the incidence of peri carditis or pericardial effusion (41 %) in patients with acute or chronic renal failure was comparable to previous studies: first described by Bright [9], it was found in 8-51 % of patients with uremia [1,4,13]. Symptoms, clini cal, electrocardiographical and echocardiographical fea tures in our patients were in accordance with previous investigations [1, 21.…”

Section: Clinical Datasupporting

confidence: 79%

“…Others have found experimental support of the hy pothesis that abnormalities in serum electrolytes engen dered by renal failure may cause pericarditis or pericar dial effusion [13], e.g. a diminished uptake of Ca2+ by the sarcoplasmatic reticulum of the heart muscle in uremic animals was observed [40], From our data it seems that, apart from biochemical reasons such as overhydration, recent episodes of viral (chills) and bacterial (shunt) infections also predispose to pericarditis.…”

Section: Clinical Datamentioning

confidence: 60%

See 1 more Smart Citation

Humoral Immune Reactions in Uremic Pericarditis

Maisch¹,

Kochsiek²

1983

Am J Nephrol

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Clinical data from 41 patients with pericarditis or pericardial effusion in acute and chronic renal failure were analyzed in respect to the diagnostic relevance of humoral immune reactions. In patients with pericardial effusion in acute renal failure due to surgery or trauma (n = 10), antimyocardial antibodies were rarely detected. In contrast, in the sera of all patients with pericarditis or pericardial effusion following renal failure in chronic or acute glomerulonephritis (n = 6), complement-fixing antisarcolemmal antibodies of the IgM and IgG classes were observed. In patients in whom pericarditis or pericardial effusion evolved during chronic hemodialysis (n = 25), the incidence of complement-fixing antimyolemmal antibodies was 64%. Only sera with complement-fixing antimyolemmal antibodies induced cytolysis of vital adult cardiocytes in vitro suggesting that the antimyolemmal antibodies may not only play a diagnostic but also a pathogenetic role in ‘uremic’ pericarditis in vivo.

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Section: Clinical Datasupporting

confidence: 79%

Section: Clinical Datamentioning

confidence: 60%

Humoral Immune Reactions in Uremic Pericarditis

Maisch¹,

Kochsiek²

1983

Am J Nephrol

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“…The correlation has not been high between the incidence of serositis and plasma levels of small or middle molecules [4,7,8,11,12]. Some indirect data suggest that very large molecules, circulating immune complexes (CIC) might be responsible for serositis in patients with renal failure.…”

Section: Introductionmentioning

confidence: 99%

Circulating Immune Complexes: Possible Toxins Responsible for Serositis (Pericarditis, Pleuritis, and Peritonitis) in Renal Failure

Twardowski¹,

Alpert²,

Gupta³

et al. 1983

Nephron

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In 71 patients (41 men, 30 women) with advanced renal failure maintained on hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), or within 8 weeks after the commencement of dialysis therapy (ED), studies were performed searching for evidence of serositis and the blood levels of circulating immune complexes (CIC), measured by the polyethylene glycol precipitation method. Mean CIC levels were elevated in these patients compared to the 58 healthy subjects (mean ± SEM 725 ± 40, and 260 ± 34 µg/ml, respectively). Serositides were significantly more prevalent in ED patients compared to both remaining groups, and tended to occur less frequently in CAPD than in HD patients. CIC levels were significantly lower in CAPD than in ED patients. The levels of CIC were significantly higher in patients with serositis compared to those without evidence of serosal inflammation (mean ± SEM 868 ± 71 and 677 ± 53 µg/ml, respectively). In addition, immune complex-like materials were found in all of 4 effusate samples and in 10 of 27 peritoneal dialysates. It is suggested that immune complexes may be the ‘uremic toxins’ responsible for the serositis of renal failure, and may be secreted into serous effusions. Immune complex-like material can be removed in peritoneal dialysate, which may contribute to the lower CIC levels and lower incidence of serositis in the CAPD patients.

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“…Pericardial effusion affects as many as 19-35% of patients with end-stage renal disease (ESRD) [1][2][3][4][5][6]. Though ESRD is the presumed cause of up to 12% of pericardial effusions categorized as small or larger than small, the pathophysiology is incompletely understood [7,8].…”

Section: Introductionmentioning

confidence: 99%