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.

pericardial disease, rheumatoid arthritis
dx.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