Recurrent pericarditis: still idiopathic? The pros and cons of a well-honoured term

Antonio Brucato, Massimo Imazio, Paul C. Cremer, Yehuda Adler, Bernhard Maisch, George Lazaros, Marco Gattorno, Alida L.P. Caforio, Renzo Marcolongo, Giacomo Emmi, Alberto Martini, Allan L. Klein

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

In developed countries, more than 80% of cases of acute pericarditis remain without an established diagnosis after a conventional and standard diagnostic approach. These cases are generally labelled as ‘idiopathic’, i.e. without a known cause. This lack of information is a matter of concern for both patients and clinicians. Some years ago, this term reflected the state of the art of scientific knowledge on the topic. Advances have changed this point of view, in light of available molecular techniques like polymerase chain reaction able to identify viral cardiotropic agents in pericardial fluid and biopsies. Furthermore, the remarkable efficacy of interleukin-1 antagonists, a therapy targeting the innate immune response, suggests clinical and pathogenic similarity between a proportion of patients with idiopathic recurrent pericarditis and classical autoinflammatory diseases. So, it seems useful to discuss the pros and cons of using the term “idiopathic” in light of the new knowledge.

Original languageEnglish
Pages (from-to)839-844
Number of pages6
JournalInternal and Emergency Medicine
Volume13
Issue number6
DOIs
Publication statusPublished - Sep 1 2018

Fingerprint

Pericarditis
Interleukin-1
Developed Countries
Innate Immunity
Biopsy
Polymerase Chain Reaction
Therapeutics
Pericardial Fluid

Keywords

  • Anakinra
  • Autoinflammatory diseases
  • Idiopathic recurrent pericarditis
  • IL-1 antagonists
  • Innate immune system
  • Pericarditis

ASJC Scopus subject areas

  • Internal Medicine
  • Emergency Medicine

Cite this

Brucato, A., Imazio, M., Cremer, P. C., Adler, Y., Maisch, B., Lazaros, G., ... Klein, A. L. (2018). Recurrent pericarditis: still idiopathic? The pros and cons of a well-honoured term. Internal and Emergency Medicine, 13(6), 839-844. https://doi.org/10.1007/s11739-018-1907-x

Recurrent pericarditis : still idiopathic? The pros and cons of a well-honoured term. / Brucato, Antonio; Imazio, Massimo; Cremer, Paul C.; Adler, Yehuda; Maisch, Bernhard; Lazaros, George; Gattorno, Marco; Caforio, Alida L.P.; Marcolongo, Renzo; Emmi, Giacomo; Martini, Alberto; Klein, Allan L.

In: Internal and Emergency Medicine, Vol. 13, No. 6, 01.09.2018, p. 839-844.

Research output: Contribution to journalReview article

Brucato, A, Imazio, M, Cremer, PC, Adler, Y, Maisch, B, Lazaros, G, Gattorno, M, Caforio, ALP, Marcolongo, R, Emmi, G, Martini, A & Klein, AL 2018, 'Recurrent pericarditis: still idiopathic? The pros and cons of a well-honoured term', Internal and Emergency Medicine, vol. 13, no. 6, pp. 839-844. https://doi.org/10.1007/s11739-018-1907-x
Brucato, Antonio ; Imazio, Massimo ; Cremer, Paul C. ; Adler, Yehuda ; Maisch, Bernhard ; Lazaros, George ; Gattorno, Marco ; Caforio, Alida L.P. ; Marcolongo, Renzo ; Emmi, Giacomo ; Martini, Alberto ; Klein, Allan L. / Recurrent pericarditis : still idiopathic? The pros and cons of a well-honoured term. In: Internal and Emergency Medicine. 2018 ; Vol. 13, No. 6. pp. 839-844.
@article{905bdb4bc8794e4abb83de7660917aa7,
title = "Recurrent pericarditis: still idiopathic? The pros and cons of a well-honoured term",
abstract = "In developed countries, more than 80{\%} of cases of acute pericarditis remain without an established diagnosis after a conventional and standard diagnostic approach. These cases are generally labelled as ‘idiopathic’, i.e. without a known cause. This lack of information is a matter of concern for both patients and clinicians. Some years ago, this term reflected the state of the art of scientific knowledge on the topic. Advances have changed this point of view, in light of available molecular techniques like polymerase chain reaction able to identify viral cardiotropic agents in pericardial fluid and biopsies. Furthermore, the remarkable efficacy of interleukin-1 antagonists, a therapy targeting the innate immune response, suggests clinical and pathogenic similarity between a proportion of patients with idiopathic recurrent pericarditis and classical autoinflammatory diseases. So, it seems useful to discuss the pros and cons of using the term “idiopathic” in light of the new knowledge.",
keywords = "Anakinra, Autoinflammatory diseases, Idiopathic recurrent pericarditis, IL-1 antagonists, Innate immune system, Pericarditis",
author = "Antonio Brucato and Massimo Imazio and Cremer, {Paul C.} and Yehuda Adler and Bernhard Maisch and George Lazaros and Marco Gattorno and Caforio, {Alida L.P.} and Renzo Marcolongo and Giacomo Emmi and Alberto Martini and Klein, {Allan L.}",
year = "2018",
month = "9",
day = "1",
doi = "10.1007/s11739-018-1907-x",
language = "English",
volume = "13",
pages = "839--844",
journal = "Internal and Emergency Medicine",
issn = "1828-0447",
publisher = "Springer-Verlag Italia s.r.l.",
number = "6",

}

TY - JOUR

T1 - Recurrent pericarditis

T2 - still idiopathic? The pros and cons of a well-honoured term

AU - Brucato, Antonio

AU - Imazio, Massimo

AU - Cremer, Paul C.

AU - Adler, Yehuda

AU - Maisch, Bernhard

AU - Lazaros, George

AU - Gattorno, Marco

AU - Caforio, Alida L.P.

AU - Marcolongo, Renzo

AU - Emmi, Giacomo

AU - Martini, Alberto

AU - Klein, Allan L.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - In developed countries, more than 80% of cases of acute pericarditis remain without an established diagnosis after a conventional and standard diagnostic approach. These cases are generally labelled as ‘idiopathic’, i.e. without a known cause. This lack of information is a matter of concern for both patients and clinicians. Some years ago, this term reflected the state of the art of scientific knowledge on the topic. Advances have changed this point of view, in light of available molecular techniques like polymerase chain reaction able to identify viral cardiotropic agents in pericardial fluid and biopsies. Furthermore, the remarkable efficacy of interleukin-1 antagonists, a therapy targeting the innate immune response, suggests clinical and pathogenic similarity between a proportion of patients with idiopathic recurrent pericarditis and classical autoinflammatory diseases. So, it seems useful to discuss the pros and cons of using the term “idiopathic” in light of the new knowledge.

AB - In developed countries, more than 80% of cases of acute pericarditis remain without an established diagnosis after a conventional and standard diagnostic approach. These cases are generally labelled as ‘idiopathic’, i.e. without a known cause. This lack of information is a matter of concern for both patients and clinicians. Some years ago, this term reflected the state of the art of scientific knowledge on the topic. Advances have changed this point of view, in light of available molecular techniques like polymerase chain reaction able to identify viral cardiotropic agents in pericardial fluid and biopsies. Furthermore, the remarkable efficacy of interleukin-1 antagonists, a therapy targeting the innate immune response, suggests clinical and pathogenic similarity between a proportion of patients with idiopathic recurrent pericarditis and classical autoinflammatory diseases. So, it seems useful to discuss the pros and cons of using the term “idiopathic” in light of the new knowledge.

KW - Anakinra

KW - Autoinflammatory diseases

KW - Idiopathic recurrent pericarditis

KW - IL-1 antagonists

KW - Innate immune system

KW - Pericarditis

UR - http://www.scopus.com/inward/record.url?scp=85050218525&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85050218525&partnerID=8YFLogxK

U2 - 10.1007/s11739-018-1907-x

DO - 10.1007/s11739-018-1907-x

M3 - Review article

C2 - 30022399

AN - SCOPUS:85050218525

VL - 13

SP - 839

EP - 844

JO - Internal and Emergency Medicine

JF - Internal and Emergency Medicine

SN - 1828-0447

IS - 6

ER -