Evaluation and treatment of pericardial disease in immune-mediated inflammatory diseases

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ID: 315555
2026
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Abstract
Pericardial disease is common in patients with immune-mediated inflammatory diseases (IMIDs), especially in systemic lupus erythematosus. Pericardial disease may present as an asymptomatic pericardial effusion or acute and recurrent pericarditis, and may sometimes lead to complications (cardiac tamponade and constrictive pericarditis). Pathophysiology of pericarditis in IMIDs is likely related to the underlying immune dysregulation. Diagnosis of IMID-related pericarditis relies on general diagnostic criteria, supported by inflammatory biomarkers and non-invasive multimodality imaging. Initial management of IMID-related pericarditis overlaps with idiopathic pericarditis (nonsteroidal anti-inflammatory drugs and colchicine) together with treatment of the underlying IMID. Glucocorticoids are used in cases of poor response to first-line treatments. The use of immunosuppressive therapies is driven by the underlying IMID and systemic organ involvement beyond the pericardium. Multi-disciplinary care collaboration between cardiologists, radiologists, internists, and rheumatologists is pivotal to develop an appropriate, common treatment plan based on the individual features of each patient with IMIDs.
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Authors Aldo Bonaventura, Michael Garshick, Danilo Malandrino, Flavio Tangianu, TARYN YOUNGSTEIN, Antonio Abbate, Brittany N Weber
Journal Lara D. Veeken
Year 2026
DOI
10.1093/rheumatology/keag283
URL
https://doi.org/10.1093/rheumatology/keag283
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