A 66-year-old man with seronegative, erosive rheumatoid arthritis for 12 years presented with malaise, elevated alkaline phosphatase and gamma-glutamyl transferase, and leg oedema. He subsequently developed ascites. No liver pathology was found, but cardiac analysis including right heart catheterisation revealed constrictive pericarditis. Rheumatoid constrictive pericarditis is a rare condition, but, despite current effective treatment for rheumatoid arthritis, still occurs. Diagnostic delay is frequent. Although mortality of the intervention is high, pericardiectomy is needed for most patients.

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doi.org/10.1136/bcr-2017-223206, hdl.handle.net/1765/106045
BMJ Case Reports
Erasmus MC: University Medical Center Rotterdam

van Soest, E.M, Liem, A.H, & van Zeben, J. (2018). Liver chemistry abnormalities and leg oedema in rheumatoid arthritis. BMJ Case Reports, 2018. doi:10.1136/bcr-2017-223206