[Rheumatic fever in the 1980's: considerations and prospects].
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Biomedical subjects
Publications and source records attributed to E Cordioli.
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The authors report a case of an acute aortic dissection in a sixty year old patient who two months previously had an ischemic cerebral vascular accident. On the basis of a remittent fever and of raised acute phase proteins the authors suspected a giant cell arteritis as possible pathogenic cause of the clinical presentation. Ruled out infective and neoplastic disorders, after an unhelpful temporal artery biopsy, steroid treatment was introduced at the recommended dosage. Three months after, while reducing steroid therapy, the acute phase proteins raised again to come back to normal values only after restoring full steroid dosage. This pattern of response to steroid treatment may further support the diagnosis of giant cell arteritis even after an unhelpful temporal artery biopsy.
The authors report the case of a sixty-seven-year-old man with seronegative rheumatoid arthritis since 1967. After the treatment was discontinued, a symptomatic pericardial effusion developed during an exacerbation of rheumatoid arthritis. Histological findings suggested a rheumatoid origin. Consecutive pericardiocentesis and a concomitant adequate treatment resolved cardiac tamponade, at least during short-term follow-up. However, a long term observation will be necessary to exclude recurrent effusion or evolutive constrictive pericarditis.