Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2016 Nov;95(44):e5305.
doi: 10.1097/MD.0000000000005305.

Cholesterol pericarditis associated with rheumatoid arthritis: A rare case report

Lin-Yan Qian  1 , Jie Pang, Xian-Da Che, Ya-Hui Ding, Hai Zou, Bing Zhou
Affiliations
Case Reports

Cholesterol pericarditis associated with rheumatoid arthritis: A rare case report

Lin-Yan Qian et al. Medicine (Baltimore). 2016 Nov.

Abstract

Background: Cholesterol pericarditis (CP) is a special type of pericarditis. It is characterized by chronic pericardial effusion with high cholesterol concentration and with or without the formation of crystals in pericardial effusion.

Methods: In this case report, we described a 74-year-old male with massive pericardial effusion. He presented with no symptoms. However, he had 8-year history of rheumatoid arthritis medicated with methotrexate, celecoxib, and prednisone, and 5-year history of hypertension medicated with amlodipine besylate. On admission, transthoracic echocardiography revealed a large pericardial effusion.

Results: We performed pericardiocentesis for this patient and a lot of cholesterol crystals were found in pericardial effusion under the microscope. A successful operation of thoracoscopic pericardiectomy was proceeded, and the diagnosis was confirmed by surgical pathology. The patient was well recovered and discharged on the tenth day after surgery. It could be predicted that pericardiectomy under video-assisted thoracoscope could be a promising therapy for CP.

Conclusion: Rheumatoid arthritis may cause CP with no symptoms. Pericardiectomy could be a promising therapy for CP.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
A large pericardial effusion was revealed by transthoracic echocardiography.
Figure 2
Figure 2
CT demonstrated interlobar effusion, pericardial effusion and a little of pleural effusion.
Figure 3
Figure 3
A lot of cholesterol crystals (indicated by red arrow) were found in pericardial effusion under the microscope.
See this image and copyright information in PMC

References

    1. Brawley RK, Vasko JS, Morrow AG. Cholesterol pericarditis. Considerations of its pathogenesis and treatment. Am J Med 1966; 41:235–248. - PubMed
    1. Adamson VW, et al. A rare case of effusive constrictive cholesterol pericarditis: a case report and review. Case Rep Med 2013; 2013:439505. - PMC - PubMed
    1. Imazio M, Gaita F, LeWinter M. Evaluation and treatment of pericarditis: a systematic review. JAMA 2015; 314:1498–1506. - PubMed
    1. Fernandes F, et al. Cholesterol pericarditis. A specific but rare cause of pericardial disease. Arq Bras Cardiol 2001; 76:391–394. - PubMed
    1. Alexander JS. A pericardial effusion of “gold-paint” appearance due to the presence of cholesterin. Br Med J 1919; 2:463. - PMC - PubMed

Publication types