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Rapid Deterioration With Evidence of Local Vasculitis

Samuel Butman, MD; Luis R. Espinoza, MD; Jaime Del Carpio, MD; C. Kirk Osterland, MD

JAMA. 1977;238(22):2394-2396.

Abstract
In a patient with classical rheumatoid arthritis and pericardial involvement, accelerated restriction of cardiac filling resulting from pericardial constriction developed. Pericardiectomy was necessary to relieve this condition. Examination of the synovial and pericardial fluid showed noteworthy decreases in total hemolytic complement (CH₅₀) and C3 levels, while these were normal in the serum. Immunofluorescence staining of the pericardium showed plasma cell infiltration and immune deposit staining of pericardial vessels with IgG, IgM, IgA, or C3. These findings suggest that immune complexes deposition plays an important role in the pathogenesis of this condition.

(JAMA 238:2394-2396, 1977)

Author Affiliations
From the Rheumatic Diseases Unit, Department of Medicine, McGill University School of Medicine, Montreal.

Footnotes
Reprint requests to Royal Victoria Hospital, 687 Pine W, Montreal, Quebec, Canada H3A 1A1 (Dr Espinoza).

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