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September 16, 1974

Steroid Therapy in Uremic Pericarditis: A Report of Three Cases

Author Affiliations

From the Department of Internal Medicine, Nephrology Section, St. Joseph Mercy Hospital, Ann Arbor, Mich.

JAMA. 1974;229(12):1634-1635. doi:10.1001/jama.1974.03230500052028

PERICARDITIS and pericardial effusion complicating uremia are usually treated with frequent dialysis, rest, and supportive care. More aggressive therapy consists of pericardiocentesis, pericardial catheterization, pericardial window, or pericardiectomy. The use of steroids has been reported with varying results.1,2 We report cases of three patients with uremic pericarditis who had effusion resistant to usual treatment, and who were treated with systemically given steroids. The response was dramatic.

Report of Cases 

Case 1.—  A 54-year-old white man was admitted to the hospital on June 6, 1972, with oliguric renal failure and uremia. A renal biopsy showed proliferative glomerulonephritis with crescents. There was no clinical or laboratory evidence of previous streptococcal infection or collagen vascular disease. He was initially treated with peritoneal dialysis. On June 18, he developed substernal chest pain, a temperature of 38 C (100.5 F), and a pericardial friction rub. An electrocardiogram showed nonspecific ST-T changes. A chest x-ray