Recurrent pericarditis revealing a systemic sarcoidosis

• Published in: La revue de medecine interne Vol. 32; no. 9; pp. 575 - 579
• Main Authors: Bocoum, A-I, Daumas, A, Cammilleri, S, Bernard, F, Rossi, P, Bagneres, D, Demoux, A-L, Aissi, K, Dales, J-P, Berdah, S, Chaumoitre, K, Frances, Y, Granel, B
• Format: Journal Article
• Language: French
• Published: France 01.09.2011
• Subjects: Female; Humans; Middle Aged; Pericarditis - etiology; Recurrence; Sarcoidosis - complications; Sarcoidosis - diagnosis
• ISSN: 1768-3122
• DOI: 10.1016/j.revmed.2011.03.007

Sarcoidosis is a systemic granulomatous disorder of unknown cause, mainly involving the lung and the mediastinum. Involvement of the pericardium and peritoneum is rare, but can be the first manifestation of the disease. A 55-year-old female patient was followed-up for a recurrent "idiopathic" pericarditis. Diagnostis was challenged when she secondarily presented with enlarged hilar and mediastinal lymph nodes associated with pulmonary "nodules". Imaging with (18)F-FDG positron emission tomography with computed tomography showed multiple hypermetabolic foci in the mediastinum and peritoneum, which suggested a malignant disorder. Finally, histopathological evaluation of the peritoneal nodules revealed a sarcoidosis. A corticosteroid therapy was initiated and disease course was favourable. This case report highlights the importance of a unique explanation for a patient presenting with recurrent pericarditis associated with a systemic disease. Although rare, sarcoidosis should be discussed and diagnostic procedures should be performed to obtain histological confirmation.