Infectious and non-infectious pericarditis in children

Pericardial diseases in children are heterogeneous in nature and can be both isolated and part of the systemic pathology. Data on the epidemiology and etiology of pericardial disease are contradictory and depend on the hospital profile, patients' age and study aims. Objective of the research-to study modern structure of pericardial diseases in children, clinical and instrumental features of individual forms and treatment tactics in real clinical practice according to the data of the Moscow multi-profile hospital. Study materials and methods: A complex clinical and laboratory-based examination was conducted in 121 patients aged from 1 month to 18 years, admitted to Morozov Children's City Clinical Hospital in Moscow in 2001-2016 with pericardium diseases. Results: pericardium inflammatory lesions were diagnosed in 86% of children, 57% of patients had infectious pericarditis (bacterial and idiopathic). The most severe course was in cases of bacterial, neoplastic pericarditis and postpericardiotomy syndrome (PPTS). A common feature of the severe course was the accumulation of a large pericardial effusion and the threat of a cardiac tamponade. In patients with idiopathic pericarditis and PPTS, herpesvirus infections markers, Mycoplasma pneumoniae, Chlamydophila pneumoniae, were more often detected with large effusions accumulation (p=0,02). Complications development was noted in 33 (27,3%) children: cardiac tamponade or the threat of its development in 23 (19%), recurrent course in 11 (9,1%). As anti-inflammatory therapy non-steroidal anti-inflammatory drugs were used (73,6% of patients); if they were inefficient-glucocorticosteroids (41,3%) and intravenous immunoglobulins (24,8%). Pericardiocentesis due to threat of cardiac tamponade was performed in 13 (10,74%) children. Conclusion: in pericarditis structure dominated infectious: bacterial and idiopathic (57%). Specific IgM antibodies to herpesviruses, Mycoplasma pneumoniae, Chlamydophila pneumoniae are possible markers of large pericardial effusion accumulation children with idiopathic pericarditis and PPTS. To assess the predictors of pericarditis adverse course incl. use of glucocorticosteroids, it is necessary to analyze long-term disease catamnesis. © 2017, Pediatria Ltd. All rights reserved.