Post-transplant recurrent pericarditis with pericardial tamponade is successfully treated with colchicine: A case report

Abstract

Recurrent pericarditis is a rare complication following renal transplantation. Colchicine, an inhibitor of microtubule polymerization, has been recommended for the treatment of recurrent acute pericarditis in non-transplant patients and is commonly used for the treatment of gout in transplant patients. However, the use of colchicine for the treatment of recurrent pericarditis in renal transplant patients has rarely been reported. In the present study, a rare case of recurrent pericarditis, manifested as large pericardial effusion and pericardial tamponade within the first year following renal transplantation, was successfully treated with colchicine. Therefore, low-dose colchicine may be a safe and effective option for the treatment of recurrent pericarditis in renal transplant patients.

Tacrolimus as a rare cause of pericardial effusion in a renal transplant recipient

“…Pericarditis leading to pericardial effusion is a very rare but known complication following renal transplantation, with a reported incidence of 2.4% in the first 2 months. [ 6 ]…”

“…Among the etiologies, tuberculosis is the most common in developing countries. [ 6 ] Uremic pericarditis is not uncommon in renal transplant patients with insufficient allograft function; however, the condition should regress along with the recovery of allograft function. [ 7 ] In certain cases, undiagnosed viral infections may be the cause, and due to the limitation of the availability and prognostic implications of etiological tests, viral causes are unable to be excluded in most of the cases.…”

Acute purulent pericarditis caused by Klebsiella Pneumonia in a patient ESRD on hemodialysis

“…Other risk factors for patients to develop Pericarditis include history of thoracic surgery, malignancy, alcohol abuse, and diabetes mellitus. [ 3 ] Our case, it is likely that it is an extension of the Klebsiella infection of the lung into the pericardial cavity that caused pericardial effusion.…”

“…[ 2 - 4 ] Although in most cases, classical gram-positive bacteria such as Staphylococcus and Streptococcus are seen, there is an emergence of gram-negative and anaerobes as well. [ 3 , 4 ] In developed countries, viral etiology is common and in the developing countries, Mycobacterium tuberculosis remains prevalent. [ 3 , 4 ] Adjacent infective foci such as pneumonia, pleural empyema, and subdiaphragmatic abscess extending into the pericardium are usually the source, others being hematogenous spread from distant foci or from wounds.…”

“…[ 3 , 4 ] In developed countries, viral etiology is common and in the developing countries, Mycobacterium tuberculosis remains prevalent. [ 3 , 4 ] Adjacent infective foci such as pneumonia, pleural empyema, and subdiaphragmatic abscess extending into the pericardium are usually the source, others being hematogenous spread from distant foci or from wounds. Other risk factors for patients to develop Pericarditis include history of thoracic surgery, malignancy, alcohol abuse, and diabetes mellitus.…”