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1 septembre 2000
- handle: 10670/1.75mpik
- hal: hal-03679805
- PUBMED: 11055006
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info:eu-repo/semantics/altIdentifier/pmid/11055006
Mots-clés
MESH: Aged MESH: Amyloidosis MESH: Pericardial Effusion MESH: Radiography, Thoracic MESH: Arthritis, Rheumatoid MESH: Biopsy MESH: Cardiomegaly MESH: Duodenal Diseases MESH: Electrocardiography MESH: Female MESH: Heart Diseases MESH: HumansSujets proches
Amyloid degenerationCiter ce document
C Giraudeau et al., « [Pericardial effusion revealing cardiac amyloidosis in the course of rheumatoid arthritis]. », HALSHS : archive ouverte en Sciences de l’Homme et de la Société, ID : 10670/1.75mpik
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Résumé
Pericardial effusion is common in patients with rheumatoid arthritis. It is essentially a sign of pericardial involvement of the rheumatoid disease, but viral, bacterial and especially tuberculous pericarditis must not be excluded. Pericardial amyloidosis of the AA type is much less common and difficult to diagnose before cardiac biopsy even in cases of myocardial amyloidosis, as in the reported case, in which the classical association of microvoltage on the ECG and myocardial hypertrophy on echocardiography was absent. The absence of myocardial uptake of technetium-labelled pyrophosphates at myocardial scintigraphy and the absence of a restrictive profile on cardiac gamma-angiography were not suggestive of the diagnosis of amyloidosis. Pericardial and endomyocardial biopsy, justified by the negativity of the preceding investigations, provided an accurate histological diagnosis, a prognostic evaluation and was also useful for guiding management.