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Huang L, Zhou Q, Cui X, Hu X, Duan D, Wu P, Gao W, Ning M, Li T. Diagnosis and etiological identification in severe constrictive pericarditis in a 14-year-old girl: a case report. Transl Pediatr 2021; 10:209-214. [PMID: 33633955 PMCID: PMC7882285 DOI: 10.21037/tp-20-203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Constrictive pericarditis in children is exceedingly rare, and may cause very problematic confusion of diagnosis and etiology identification. In this case, we examined a 14-year-old female patient who had developed signs of significant anasarca which was eventually turned out to be constrictive pericarditis. Affected by the experience of examiners, the patient was not diagnosed or even suspected with constrictive pericarditis when she was initially examined by echocardiography in the hospital where she visited before. Reexamination of echocardiography, cardiac catheterization and non-invasive image techniques were performed to establish the diagnosis finally. Open pericardectomy was ultimately performed and normal hemodynamic parameters and cardiac function were obtained postoperatively. In the determination of etiology, we inferred that chronic infection induced by local virus infection in the pericardium led to constrictive pericarditis. Parvovirus B19 (PVB19) and/or human herpes virus 6 (HHV-6) were the two most likely viruses involved based on published literature reviews. Importantly, we learned that serological antibody testing may be false-negative and polymerase chain reaction (PCR) or metagenomic next-generation sequencing for pericardial viral nucleic acid testing may be the gold standard for confirmation. Unfortunately, fresh pericardial tissue samples were not taken before paraformaldehyde fixation in our case, which made it impossible for us to detect suspicious viruses. We do hope that the lessons learned from this case will be helpful and instructive for the etiological diagnosis of similar patients in the future.
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Affiliation(s)
- Lei Huang
- Department of Heart Center, Tianjin Third Central Hospital, Tianjin, China.,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Quan Zhou
- Department of Heart Center, Tianjin Third Central Hospital, Tianjin, China.,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Xiaoqiong Cui
- Department of Heart Center, Tianjin Third Central Hospital, Tianjin, China.,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Xiaomin Hu
- Department of Heart Center, Tianjin Third Central Hospital, Tianjin, China.,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Dawei Duan
- Department of Heart Center, Tianjin Third Central Hospital, Tianjin, China.,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Peng Wu
- Department of Heart Center, Tianjin Third Central Hospital, Tianjin, China.,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Wenqing Gao
- Department of Heart Center, Tianjin Third Central Hospital, Tianjin, China.,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Meng Ning
- Department of Heart Center, Tianjin Third Central Hospital, Tianjin, China.,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
| | - Tong Li
- Department of Heart Center, Tianjin Third Central Hospital, Tianjin, China.,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
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Demaria R, Fortier S, Racine N, Dürrleman N, Albat B, Frapier JM, Chaptal PA. [Chronic constrictive pericarditis in African children: report of a case]. Ann Cardiol Angeiol (Paris) 2001; 50:312-5. [PMID: 12555621 DOI: 10.1016/s0003-3928(01)00038-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The chronic constrictive pericarditis is a rare affection, with multiple etiologies and concerning especially the adult. We report a case of chronic constrictive pericarditis in an African child in whom no etiology was found. A review of the literature raises the characteristics of chronic constrictive pericarditis for a better therapeutic management.
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Affiliation(s)
- R Demaria
- Départements de chirurgie et de cardiologie, institut de cardiologie de Montréal, 5000 Bélanger Est, H1T 1C8, Montréal, Québec, Canada.
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