Interferon-α and pericardial injury: a case report and literature review

Abstract

Interferon- α (IFN-α) alone or in combination with other chemotherapeutic agents has been used in the management of many malignant and non-malignant conditions. Pericarditis with or without pericardial effusion has been reported with IFN-α therapy, and available literature is limited to case reports. Pericardial constriction after interferon use has not been described in the published literature to date. We performed a systematic review of literature to address the demographic features, clinical presentation, diagnosis, treatment and outcome of interferon-related pericardial injury.

Figure 1

Computed tomography scan of chest showing pericardial effusion and bilateral pleural effusion (A). Transthoracic echocardiography (subcostal view) showing circumferential pericardial effusion and diastolic collapse of right ventricular free wall (asterix) (B).

Figure 2

An H & E-stained section of pericardium shows a fibrohistiocytic proliferation (arrows) in a background of acute and chronic inflammatory cells (20×, HE).

Figure 3

Mitral (A) and tricuspid (B) inflow Doppler signals with respirometer showing >25% change in mitral and >40% change in tricuspid inflow Doppler velocities during respiratory cycle consistent with pericardial constriction.

Figure 4

Magnetic resonance imaging with gadolinium showing delayed enhancement of the pericardium (arrows).