Uremic Pericarditis: A Report of 30 Cases and Review of the Literature

PATIENT Male, 71 • Male, 69 • . Female, 49. FINAL DIAGNOSIS Uremic pericarditis. SYMPTOMS — MEDICATION — CLINICAL PROCEDURE Hemodialysis. SPECIALTY Nephrology. OBJECTIVE Rare disease. BACKGROUND Uremic pericarditis, common at one time among dialysis patients, has become a rare entity in recent years. Due to its low incidence, its recognition has gained importance among internists, cardiologists, and nephrologists. It can be seen in predialysis patients and in dialysis patients who are on hemodialysis or peritoneal dialysis. CASE REPORT We report 3 cases of uremic pericarditis and their presenting manifestations and review 30 cases we have treated. Among these patients, the traditional findings among patients with acute pericarditis such as chest pain, fever, electrocardiographic changes, and leukocytosis are uncommon. Pericardial friction rub has a relatively high incidence but its differentiation by an untrained ear, especially by a non-cardiologist, could be a major problem. Not infrequently, it is complicated by pre-tamponade or tamponade, requiring pericardiocentesis or pericardial surgery. CONCLUSIONS Uremic pericarditis is a treatable, but not always a preventable, condition. Timely recognition of its presence and its efficient management are essential elements of successful treatment.