Pericarditis in Patients with Autoimmune Disease: Insights into Prevalence and Optimal Management
By: Yeva Fakikh, Sarah Kazzaz and Maan Malahfji
References
- Conrad N, Misra S, Verbakel JY, et al. Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. Lancet. 2023 Jun 3;401(10391):1878-1890. doi: 10.1016/S0140-6736(23)00457-9
- Imazio M, Gaita F, LeWinter M. Evaluation and Treatment of Pericarditis: A Systematic Review. JAMA. 2015 Oct 13;314(14):1498-506. doi: 10.1001/jama.2015.12763
- Wassif H, Ghandakly E, Layoun H, et al. Autoimmune Pericarditis: Diagnosis and New Therapeutics. Curr Cardiol Rep. 2025 Jul 15;27(1):
114 . doi: 10.1007/s11886-025-02248-1 - Cantarini L, Imazio M, Brizi MG, et al. Role of autoimmunity and autoinflammation in the pathogenesis of idiopathic recurrent pericarditis. Clin Rev Allergy Immunol. 2013 Feb;44(1):6-13. doi: 10.1007/s12016-010-8219-x
- Imazio M, Battaglia A, Gaido L, Gaita F. Recurrent pericarditis. Rev Med Interne. 2017 May;38(5):307-311. doi: 10.1016/j.revmed.2016.12.006
- Kawano Y, Pabón MA, Feldman CH, et al. Evaluation and Management of Pericarditis in Rheumatic Diseases. J Cardiovasc Pharmacol. 2024 Jun 1;83(6):491-502. doi: 10.1097/FJC.0000000000001494
- Kim YJ, Lovell J, Diab A, et al. Incidence and Factors Associated With Recurrent Pericarditis in Lupus. JAMA Netw Open. 2025 Feb 3;8(2):
e2461610 . doi: 10.1001/jamanetworkopen.2024.61610 - Ryu S, Fu W, Petri MA. Associates and predictors of pleurisy or pericarditis in SLE. Lupus Sci Med. 2017 Oct 23;4(1):
e000221 . doi: 10.1136/lupus-2017-000221 - Kontzias A, Barkhodari A, Yao Q. Pericarditis in Systemic Rheumatologic Diseases. Curr Cardiol Rep. 2020 Sep 10;22(11):
142 . doi: 10.1007/s11886-020-01415-w - Voskuyl AE. The heart and cardiovascular manifestations in rheumatoid arthritis. Rheumatology (Oxford). 2006 Oct;45 Suppl 4:iv4-7. doi: 10.1093/rheumatology/kel313
- Nakamura Y, Izumi C, Nakagawa Y, Hatta K. A case of effusive-constrictive pericarditis accompanying rheumatoid arthritis: The possibility of adverse effect of TNF-inhibitor therapy. J Cardiol Cases. 2012 Sep 25;7(1):e8-e10. doi: 10.1016/j.jccase.2012.08.007
- Yousuf T, Kramer J, Kopiec A, Bulwa Z, Sanyal S, Ziffra J. A Rare Case of Cardiac Tamponade Induced by Chronic Rheumatoid Arthritis. J Clin Med Res. 2015 Sep;7(9):720-3. doi: 10.14740/jocmr2226w
- Ammirati E, Bizzi E, Veronese G, et al. Immunomodulating Therapies in Acute Myocarditis and Recurrent/Acute Pericarditis. Front Med (Lausanne). 2022 Mar 7;9:
838564 . doi: 10.3389/fmed.2022.838564 - Miloslavsky E, Unizony S. The heart in vasculitis. Rheum Dis Clin North Am. 2014 Feb;40(1):11-26. doi: 10.1016/j.rdc.2013.10.006
- Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015 Nov 7;36(42):2921-2964. doi: 10.1093/eurheartj/ehv318
- Mann DL. The Emerging Field of Cardioimmunology: Past, Present and Foreseeable Future. Circ Res. 2024 Jun 7;134(12):1663-1680. doi: 10.1161/CIRCRESAHA.123.323656
- Thorolfsdottir RB, Jonsdottir AB, Sveinbjornsson G, et al. Variants at the Interleukin 1 Gene Locus and Pericarditis. JAMA Cardiol. 2024 Feb 1;9(2):165-172. doi: 10.1001/jamacardio.2023.4820
- Bidani AK, Roberts JL, Schwartz MM, Lewis EJ. Immunopathology of cardiac lesions in fatal systemic lupus erythematosus. Am J Med. 1980 Dec;69(6):849-58. doi: 10.1016/s0002-9343(80)80010-6
- Perricone C, Ciccacci C, Ceccarelli F, et al. TRAF3IP2 gene and systemic lupus erythematosus: association with disease susceptibility and pericarditis development. Immunogenetics. 2013 Oct;65(10):703-9. doi: 10.1007/s00251-013-0717-6
- Butman S, Espinoza LR, Del Carpio J, Osterland CK. Rheumatoid pericarditis. Rapid deterioration with evidence of local vasculitis. JAMA. 1977 Nov 28;238(22):2394-6. doi: 10.1001/jama.238.22.2394
- Ozaki Y, Tanaka A, Shimamoto K, et al. A case of rheumatoid pericarditis associated with a high IL-6 titer in the pericardial fluid and tocilizumab treatment. Mod Rheumatol. 2011 Jun;21(3):302-4. doi: 10.1007/s10165-010-0377-4
- Cremer PC, Klein AL, Imazio M. Diagnosis, Risk Stratification, and Treatment of Pericarditis: A Review. JAMA. 2024 Oct 1;332(13):1090-1100. doi: 10.1001/jama.2024.12935
- Imazio M. Pericardial involvement in systemic inflammatory diseases. Heart. 2011 Nov;97(22):1882-92. doi: 10.1136/heartjnl-2011-300054
- Jain V, Chhabra G, Chetrit M, et al. Role of non-invasive multimodality imaging in autoimmune pericarditis. Eur Heart J Cardiovasc Imaging. 2021 Oct 19;22(11):1228-1240. doi: 10.1093/ehjci/jeab131
- Wasir AS, Darak A, Doad J, Bharadwaj P, Kalra R. Autoimmune fulminant myopericarditis presenting as cardiac tamponade-A rare occurrence in a patient with systemic lupus erythematosus. JRSM Cardiovasc Dis. 2025 Aug 11:14:20480040251368556. doi: 10.1177/20480040251368556
- Klein AL, Wang TKM, Cremer PC, et al. Pericardial Diseases: International Position Statement on New Concepts and Advances in Multimodality Cardiac Imaging. JACC Cardiovasc Imaging. 2024 Aug;17(8):937-988. doi: 10.1016/j.jcmg.2024.04.010
- Aun JA, Kwong R, Weber B. Cardiac MRI in Rheumatic Disease. Rheum Dis Clin North Am. 2024 Nov;50(4):735-756. doi: 10.1016/j.rdc.2024.07.010
- Imazio M, Brucato A, Cumetti D, et al. Corticosteroids for recurrent pericarditis: high versus low doses: a nonrandomized observation. Circulation. 2008 Aug 5;118(6):667-71. doi: 10.1161/CIRCULATIONAHA.107.761064
- Humphrey MB, Russell L, Danila MI, et al. 2022 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Rheumatol. 2023 Dec;75(12):2088-2102. doi: 10.1002/art.42646
- Bhatt DL, Scheiman J, Abraham NS, et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation. 2008 Oct 28;118(18):1894-909. doi: 10.1161/CIRCULATIONAHA.108.191087
- Brucato A, Imazio M, Gattorno M, et al. Effect of Anakinra on Recurrent Pericarditis Among Patients With Colchicine Resistance and Corticosteroid Dependence: The AIRTRIP Randomized Clinical Trial. JAMA. 2016 Nov 8;316(18):1906-1912. doi: 10.1001/jama.2016.15826
- Cafarelli F, Coladonato L, Lopalco G, Cacciapaglia F, Cantarini L, Iannone F. Successful treatment with anakinra of refractory pericarditis in systemic lupus erythematosus. Clin Exp Rheumatol. 2021 Jan-Feb;39(1):
227 . doi: 10.55563/clinexprheumatol/n0gibi - Klein AL, Imazio M, Cremer P, et al. Phase 3 Trial of Interleukin-1 Trap Rilonacept in Recurrent Pericarditis. N Engl J Med. 2021 Jan 7;384(1):31-41. doi: 10.1056/NEJMoa2027892
- Fava A, Cammarata M, Adamo L. Rilonacept use in lupus pericarditis. Clin Exp Rheumatol. 2024 May;42(5):1115-1117. doi: 10.55563/clinexprheumatol/pb3hzb
- Morel N, Bonjour M, Le Guern V, et al. Colchicine: a simple and effective treatment for pericarditis in systemic lupus erythematosus? A report of 10 cases. Lupus. 2015 Dec;24(14):1479-85. doi: 10.1177/0961203315593169
- Imazio M, Lazaros G, Picardi E, et al. Intravenous human immunoglobulins for refractory recurrent pericarditis: a systematic review of all published cases. J Cardiovasc Med (Hagerstown). 2016 Apr;17(4):263-9. doi: 10.2459/JCM.0000000000000260
- Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update on the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis. 2021 Jan;80(1):14-25. doi: 10.1136/annrheumdis-2020-218272
- Kirou KA, Dall Era M, Aranow C, Anders HJ. Belimumab or anifrolumab for systemic lupus erythematosus? A risk-benefit assessment. Front Immunol. 2022 Aug 31:13:
980079 . doi: 10.3389/fimmu.2022.980079 - Hara S, Okada T, Moriyama M, Ichinose K, Tanabe K. A Case of Refractory Systemic Lupus Erythematosus-Associated Pericarditis Treated with Anifrolumab. Intern Med. 2025 Oct 16. doi: 10.2169/internalmedicine.5974-25
- Taylan A. Rituximab therapy in pericarditis associated with rheumatoid arthritis. Rheumatol Int. 2022 Oct;42(10):1843-1847. doi: 10.1007/s00296-021-05080-2
DOI: https://doi.org/10.14797/mdcvj.1780 | Journal eISSN: 1947-6108
Language: English
Page range: 50 - 59
Submitted on: Jan 6, 2026
Accepted on: Feb 2, 2026
Published on: Mar 10, 2026
Published by: Houston Methodist DeBakey Heart & Vascular Center
In partnership with: Paradigm Publishing Services
Keywords:
© 2026 Yeva Fakikh, Sarah Kazzaz, Maan Malahfji, published by Houston Methodist DeBakey Heart & Vascular Center
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.