Rheumatoid pericarditis. Rapid deterioration with evidence of local vasculitis

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Abstract
In a patient with classical rheumatoid arthritis and pericardial involvement, accelerated restriction of cardiac filling resulting from pericardial constriction developed. Pericardiectomy was necessary to relieve this condition. Examination of the synovial and pericardial fluid showed noteworthy decreases in total hemolytic complement (CH50) and C3 [complement component 3] levels, while these were normal in the serum. Immunofluorescence staining of the pericardium showed plasma cell infiltration and immune deposit staining of pericardial vessels with Ig[immunoglobulin]G, IgM, IgA or C3. Immune complex deposition appears to play an important role in the pathogenesis of this condition.