Title:Clinical and Laboratory Evaluation of Acute Pericarditis Associated with
Antinuclear Antibodies Positivity
Volume: 21
Issue: 1
Author(s): Ali Doğan Dursun, Ersin Saricam*, Hakan Erdem, Gulcin Turkmen Sariyildiz, Esref Umut Ozyer, Engin Bozkurt, Erdogan Ilkay and Ömer Faruk Cantekin
Affiliation:
- Department of Cardiology, Medicana
International Ankara Hospital, Ankara, Turkey
Keywords:
Acute pericarditis, antinuclear antibodies positivity, female, oxidative stress, serum parameters, slow venous flow.
Abstract:
Background: Up to 30% of patients with acute pericarditis develop recurrent pericarditis.
Acute pericarditis may be a manifestation of an underlying systemic autoimmune disease. Therefore, we
evaluated the characteristics of patients with acute pericarditis according to antinuclear antibodies
(ANA) positivity/negativity.
Methods: Participants with acute pericarditis and negative ANA (n=29), recurrent pericarditis with positive
ANA (n=30) and healthy controls (n=11) were examined. The groups were compared using serum
parameters (ANA, C-reactive protein, leucocyte count, erythrocyte sedimentation rate, total antioxidant
status, nitric oxide (NO), and oxidative stress index (OSI)) and imaging techniques (electrocardiogram,
echocardiography, cardiovascular magnetic resonance, and venous Doppler ultrasound).
Results: In females, acute pericarditis associated with ANA occurred more frequently (p<0.001). ANApositive
acute pericarditis had significantly lower NO and OSI (p<0.05 and p<0.001, respectively) and
pericardial inflammation on magnetic resonance. We found a pulmonary embolism in one patient with
positive ANA. Slow venous flow (SVF) occurred more often in acute pericarditis associated with ANA
than in the ANA-negative group on venous ultrasound (p<0.05). The prevalence of positive ANAs was
1.6 times higher among SVF patients than in controls.
Conclusion: This study suggests that acute pericarditis associated with ANA is more common in middle-
aged females. SVF and lower oxidative stress tests were more common in patients with ANAassociated
acute pericarditis. Acute pericarditis associated with ANA could be considered as a hypercoagulable
state. Therefore, all newly diagnosed pericarditis patients (especially females) should be
checked for ANA positivity. Awareness of this coexistence should be promptly addressed to establish
management strategies.
