Aggiornamento
Pericarditi acute e ricorrenti in Pediatria
Acute and recurrent pericarditis in paediatrics
Sara Della Paolera1, Elena Favaretto1, Marco Bobbo2, Egidio Barbi1,2, Giulia Gortani2
11Università di Trieste, 2IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
Settembre 2021 - pagg. 425 -431 | DOI: 10.53126/MEB40425
Abstract
Chest pain in children and adolescents is rarely associated with an underlying heart disease. How-ever, when it does occur, pericarditis is the most common cause. Most cases are of unknown origin (idiopathic) and mild. Up to 15-35% of paediatric patients with idiopathic pericarditis experience a recurrence during their lives and clinical management in these cases may be challenging. NSAIDs are the first-choice drugs for the treatment of acute idiopathic pericarditis. Corticosteroids should be reserved for refractory pericarditis and autoimmune or autoinflammatory disorders with peri-cardial involvement. Colchicine plays a central role for the management of recurrent forms while anakinra has recently emerged as a remedy for colchicine-resistant and corticosteroid-dependent recurrent pericarditis.
Riassunto
La pericardite è la causa più frequente di dolore toracico nel bambino che giunge al PS, sebbene in pediatria questo sintomo sia da imputare raramente ad un problema cardiaco. Il dolore toracico in pronto soccorso pediatrico ha solo raramente a che fare con il cuore, ma in quei rari casi la pericardite è la diagnosi più probabile. Nella maggior parte dei casi si tratta di forme virali o idiopatiche, benigne per il basso tasso di complicanze, ma gravate da un alto tasso di ricorrenza compreso tra il 15 e il 35% del totale. La terapia prevede l’utilizzo di farmaci anti-infiammatori non steroidei (FANS) e il riposo dall’attività fisica. I corticosteroidi vanno riservati alle forme resistenti o ai casi di pericardite ricorrente secondaria a patologia immunomediata. La colchicina ha un ruolo centrale nella prevenzione delle forme ricorrenti e negli ultimi anni sono sempre maggiori le prove di efficacia a sostegno dell’Anakinra nelle forme colchicino-resistenti o cortico-dipendenti.
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Classificazione MeSH
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Corrispondenza: saradellapaolera@gmail.com