HIV induced pericarditis pathophysiology: Difference between revisions
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{{HIV induced pericarditis}} | {{HIV induced pericarditis}} | ||
{{Pericarditis}} | {{Pericarditis}} | ||
{{CMG}}; {{AE}} {{RG}} | {{CMG}}; {{AE}} {{RG}} | ||
==Overview== | |||
Pericardial effusion is common among asymptomatic HIV positive patients, it may cause large [[Cardiac tamponade|tamponade]]. Heart involvement is one of the most co-morbidity of [[HIV]] patients because. Since the improvement of anti retro viral therapies, other causes of AIDS mortality have decreased, and pericarditis began to be the leading cause. | |||
==Pathophysiology== | ==Pathophysiology== | ||
===Pathogenesis=== | |||
*[[Pericardial effusion]] is common among asymptomatic HIV positive patients. | |||
*Large effusions causing [[Cardiac tamponade|tamponade]] is rare.<ref name="RemickGeorgiopoulou2014">{{cite journal|last1=Remick|first1=Joshua|last2=Georgiopoulou|first2=Vasiliki|last3=Marti|first3=Catherine|last4=Ofotokun|first4=Igho|last5=Kalogeropoulos|first5=Andreas|last6=Lewis|first6=William|last7=Butler|first7=Javed|title=Heart Failure in Patients With Human Immunodeficiency Virus Infection|journal=Circulation|volume=129|issue=17|year=2014|pages=1781–1789|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.113.004574}}</ref> | |||
*[[HIV AIDS medical therapy|HAART]] therapy regimen of HIV positive patients has decreased the incidence of [[pericarditis]] and [[pericardial effusion]] considerably. | |||
*HIV related [[pericarditis]] is usually caused by tuberculosis.<ref name="MorenoVillacastín1997">{{cite journal|last1=Moreno|first1=Raùl|last2=Villacastín|first2=Julián P|last3=Bueno|first3=Héctor|last4=López de Sá|first4=Esteban|last5=López-Sendón|first5=José L|last6=Bobadilla|first6=Jaime F|last7=García-Fernández|first7=Miguel A|last8=Delcán|first8=Juan L.|title=Clinical and Echocardiographic Findings in HIV Patients with Pericardial Effusion|journal=Cardiology|volume=88|issue=5|year=1997|pages=397–400|issn=1421-9751|doi=10.1159/000177367}}</ref> | |||
*associated [[myocarditis]] is present in approximately one -third of cases. | |||
*It has high mortality.<ref name="SudanoSpieker2006">{{cite journal|last1=Sudano|first1=Isabella|last2=Spieker|first2=Lukas E.|last3=Noll|first3=Georg|last4=Corti|first4=Roberto|last5=Weber|first5=Rainer|last6=Lüscher|first6=Thomas F.|title=Cardiovascular disease in HIV infection|journal=American Heart Journal|volume=151|issue=6|year=2006|pages=1147–1155|issn=00028703|doi=10.1016/j.ahj.2005.07.030}}</ref> | |||
*[[pericardiocentesis]] is essential in order to a diagnosis of the main cause of pericardial effusion<ref name="pmid9432393">{{cite journal |author=Maher D, Harries AD |title=Tuberculous pericardial effusion: a prospective clinical study in a low-resource setting--Blantyre, Malawi |journal=[[The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease]] |volume=1 |issue=4 |pages=358–64 |year=1997 |month=August |pmid=9432393 |doi= |url=}}</ref><ref name="pmid9411548">{{cite journal |author=Dronda F, Suzacq C |title=[Pericardial tuberculosis complicated with heart tamponade as presentation form of acquired immunodeficiency syndrome] |language=Spanish; Castilian |journal=[[Revista Clínica Española]] |volume=197 |issue=7 |pages=502–6 |year=1997 |month=July |pmid=9411548 |doi= |url=}}</ref>. | |||
*However, majority of the cases of [[pericarditis]] are of unknown etiology. Other causes of pericarditis in AIDS include <ref name="pmid10047635">{{cite journal |author=Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M |title=Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature |journal=[[American Heart Journal]] |volume=137 |issue=3 |pages=516–21 |year=1999 |month=March |pmid=10047635 |doi= |url=}}</ref><ref name="pmid7781340">{{cite journal |author=Flum DR, McGinn JT, Tyras DH |title=The role of the 'pericardial window' in AIDS |journal=[[Chest]] |volume=107 |issue=6 |pages=1522–5 |year=1995 |month=June |pmid=7781340 |doi= |url=}}</ref><ref name="pmid9583822">{{cite journal |author=Gouny P, Lancelin C, Girard PM, Hocquet-Cheynel C, Rozenbaum W, Nussaume O |title=Pericardial effusion and AIDS: benefits of surgical drainage |journal=[[European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery]] |volume=13 |issue=2 |pages=165–9 |year=1998 |month=February |pmid=9583822 |doi= |url=}}</ref><ref name="pmid1516433">{{cite journal |author=Eisenberg MJ, Gordon AS, Schiller NB |title=HIV-associated pericardial effusions |journal=[[Chest]] |volume=102 |issue=3 |pages=956–8 |year=1992 |month=September |pmid=1516433 |doi= |url=}}</ref>: | |||
**[[Staphylococcus|Staphylococcal]] infection | |||
**[[Streptococcus|Streptococcal]] infection | |||
**[[Lymphoma]] | |||
**[[Kaposi's sarcoma|Kaposi sarcoma]] | |||
** Atypical [[Mycobacterium|mycobacteria]] | |||
**''[[Nocardia|Nocardia asteroides]]'' | |||
**''[[Listeria monocytogenes]]'' | |||
**''[[Rhodococcus equi]]'' | |||
**''[[Chlamydia trachomatis]]'' | |||
**Rarely [[Cryptococcus]], and [[Aspergillus]] | |||
[[File:PMC4908798 12917 2016 731 Fig2 HTML.png|center|500px|thumbnail|a) tuberculoma in the left atrium (black arrow); b numerous small foci of granulomatous inflammation diffusely scattered thorough the liver; c) numerous subcapsular small foci of granulomatous inflammation in the kidney (black arrow), note irregular shape of the organ<ref name="Szaluś-JordanowAugustynowicz-Kopeć2016">{{cite journal|last1=Szaluś-Jordanow|first1=Olga|last2=Augustynowicz-Kopeć|first2=Ewa|last3=Czopowicz|first3=Michał|last4=Olkowski|first4=Arkadiusz|last5=Łobaczewski|first5=Andrzej|last6=Rzewuska|first6=Magdalena|last7=Sapierzyński|first7=Rafał|last8=Wiatr|first8=Elżbieta|last9=Garncarz|first9=Magdalena|last10=Frymus|first10=Tadeusz|title=Intracardiac tuberculomas caused by Mycobacterium tuberculosis in a dog|journal=BMC Veterinary Research|volume=12|issue=1|year=2016|issn=1746-6148|doi=10.1186/s12917-016-0731-7}}</ref>]] | |||
[[File:PMC5149593 CRIC2016-1297869.003.png|center|500px|thumbnail| Bread and butter appearance upon opening the pericardium. The “bread and butter” appearance seen upon separating the visceral and parietal surfaces of the pericardium during surgery is typical for fibrinous pericarditis.<ref name="WoudstraBoink2016">{{cite journal|last1=Woudstra|first1=Odilia I.|last2=Boink|first2=Gerard J. J.|last3=Winkelman|first3=Jacobus A.|last4=van Stralen|first4=Ron|title=A Rare Case of Primary Meningococcal Myopericarditis in a 71-Year-Old Male|journal=Case Reports in Cardiology|volume=2016|year=2016|pages=1–3|issn=2090-6404|doi=10.1155/2016/1297869}}</ref>]] | |||
==Microscopic Pathology== | |||
*On microscopic histopathological analysis, acid fast bacilli is a characteristic findings of tuberculous pericarditis. | |||
[[File:PMC3286783 jkms-27-325-g005.png|center|500px|thumbnail|(A) A pink, amorphous meshwork of threads admixed with degenerated red blood cells and leukocytes (H&E stain, × 400). (B) Numerous acid-fast bacilli (Ziehl-Neelsen stain, × 1,000)<ref name="YoonHahn2012">{{cite journal|last1=Yoon|first1=Shin-Ae|last2=Hahn|first2=Youn-Soo|last3=Hong|first3=Jong Myeon|last4=Lee|first4=Ok-Jun|last5=Han|first5=Heon-Seok|title=Tuberculous Pericarditis Presenting as Multiple Free Floating Masses in Pericardial Effusion|journal=Journal of Korean Medical Science|volume=27|issue=3|year=2012|pages=325|issn=1011-8934|doi=10.3346/jkms.2012.27.3.325}}</ref>]] | |||
* Kaposi's sarcoma induced pericarditis is defined if the pathology exists in organs as described below:(pericarditis may be the first manifestation) | |||
[[File:PMC3214679 cro0004-0439-f01.png|center|thumbnail|Elongated spindle cells are separated by slits containing red blood cells in lymph node with Kaposi's sarcoma (hematoxylin and eosin stain, ×200) (a), anti-HHV-8 antibody immunostaining positivity detected in the lymph node (×400) (b).<ref name="AydinEskazan2011">{{cite journal|last1=Aydin|first1=Seniz Ongoren|last2=Eskazan|first2=Ahmet Emre|last3=Aki|first3=Hilal|last4=Ozguroglu|first4=Mustafa|last5=Baslar|first5=Zafer|last6=Soysal|first6=Teoman|title=Synchronous Detection of Hairy Cell Leukemia and HIV-Negative Kaposi’s Sarcoma of the Lymph Node: A Diagnostic Challenge and a Rare Coincidence|journal=Case Reports in Oncology|volume=4|issue=3|year=2011|pages=439–444|issn=1662-6575|doi=10.1159/000331894}}</ref>]] | |||
==References== | ==References== | ||
Latest revision as of 13:31, 3 January 2020
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HIV induced pericarditis Microchapters |
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Differentiating HIV Induced Pericarditis from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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HIV induced pericarditis pathophysiology On the Web |
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American Roentgen Ray Society Images of HIV induced pericarditis pathophysiology |
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Risk calculators and risk factors for HIV induced pericarditis pathophysiology |
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Pericarditis Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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HIV induced pericarditis pathophysiology On the Web |
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American Roentgen Ray Society Images of HIV induced pericarditis pathophysiology |
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Risk calculators and risk factors for HIV induced pericarditis pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]
Overview
Pericardial effusion is common among asymptomatic HIV positive patients, it may cause large tamponade. Heart involvement is one of the most co-morbidity of HIV patients because. Since the improvement of anti retro viral therapies, other causes of AIDS mortality have decreased, and pericarditis began to be the leading cause.
Pathophysiology
Pathogenesis
- Pericardial effusion is common among asymptomatic HIV positive patients.
- Large effusions causing tamponade is rare.[1]
- HAART therapy regimen of HIV positive patients has decreased the incidence of pericarditis and pericardial effusion considerably.
- HIV related pericarditis is usually caused by tuberculosis.[2]
- associated myocarditis is present in approximately one -third of cases.
- It has high mortality.[3]
- pericardiocentesis is essential in order to a diagnosis of the main cause of pericardial effusion[4][5].
- However, majority of the cases of pericarditis are of unknown etiology. Other causes of pericarditis in AIDS include [6][7][8][9]:
- Staphylococcal infection
- Streptococcal infection
- Lymphoma
- Kaposi sarcoma
- Atypical mycobacteria
- Nocardia asteroides
- Listeria monocytogenes
- Rhodococcus equi
- Chlamydia trachomatis
- Rarely Cryptococcus, and Aspergillus
Microscopic Pathology
- On microscopic histopathological analysis, acid fast bacilli is a characteristic findings of tuberculous pericarditis.
- Kaposi's sarcoma induced pericarditis is defined if the pathology exists in organs as described below:(pericarditis may be the first manifestation)
References
- ↑ Remick, Joshua; Georgiopoulou, Vasiliki; Marti, Catherine; Ofotokun, Igho; Kalogeropoulos, Andreas; Lewis, William; Butler, Javed (2014). "Heart Failure in Patients With Human Immunodeficiency Virus Infection". Circulation. 129 (17): 1781–1789. doi:10.1161/CIRCULATIONAHA.113.004574. ISSN 0009-7322.
- ↑ Moreno, Raùl; Villacastín, Julián P; Bueno, Héctor; López de Sá, Esteban; López-Sendón, José L; Bobadilla, Jaime F; García-Fernández, Miguel A; Delcán, Juan L. (1997). "Clinical and Echocardiographic Findings in HIV Patients with Pericardial Effusion". Cardiology. 88 (5): 397–400. doi:10.1159/000177367. ISSN 1421-9751.
- ↑ Sudano, Isabella; Spieker, Lukas E.; Noll, Georg; Corti, Roberto; Weber, Rainer; Lüscher, Thomas F. (2006). "Cardiovascular disease in HIV infection". American Heart Journal. 151 (6): 1147–1155. doi:10.1016/j.ahj.2005.07.030. ISSN 0002-8703.
- ↑ Maher D, Harries AD (1997). "Tuberculous pericardial effusion: a prospective clinical study in a low-resource setting--Blantyre, Malawi". The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 1 (4): 358–64. PMID 9432393. Unknown parameter
|month=ignored (help) - ↑ Dronda F, Suzacq C (1997). "[Pericardial tuberculosis complicated with heart tamponade as presentation form of acquired immunodeficiency syndrome]". Revista Clínica Española (in Spanish; Castilian). 197 (7): 502–6. PMID 9411548. Unknown parameter
|month=ignored (help) - ↑ Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M (1999). "Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature". American Heart Journal. 137 (3): 516–21. PMID 10047635. Unknown parameter
|month=ignored (help) - ↑ Flum DR, McGinn JT, Tyras DH (1995). "The role of the 'pericardial window' in AIDS". Chest. 107 (6): 1522–5. PMID 7781340. Unknown parameter
|month=ignored (help) - ↑ Gouny P, Lancelin C, Girard PM, Hocquet-Cheynel C, Rozenbaum W, Nussaume O (1998). "Pericardial effusion and AIDS: benefits of surgical drainage". European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery. 13 (2): 165–9. PMID 9583822. Unknown parameter
|month=ignored (help) - ↑ Eisenberg MJ, Gordon AS, Schiller NB (1992). "HIV-associated pericardial effusions". Chest. 102 (3): 956–8. PMID 1516433. Unknown parameter
|month=ignored (help) - ↑ Szaluś-Jordanow, Olga; Augustynowicz-Kopeć, Ewa; Czopowicz, Michał; Olkowski, Arkadiusz; Łobaczewski, Andrzej; Rzewuska, Magdalena; Sapierzyński, Rafał; Wiatr, Elżbieta; Garncarz, Magdalena; Frymus, Tadeusz (2016). "Intracardiac tuberculomas caused by Mycobacterium tuberculosis in a dog". BMC Veterinary Research. 12 (1). doi:10.1186/s12917-016-0731-7. ISSN 1746-6148.
- ↑ Woudstra, Odilia I.; Boink, Gerard J. J.; Winkelman, Jacobus A.; van Stralen, Ron (2016). "A Rare Case of Primary Meningococcal Myopericarditis in a 71-Year-Old Male". Case Reports in Cardiology. 2016: 1–3. doi:10.1155/2016/1297869. ISSN 2090-6404.
- ↑ Yoon, Shin-Ae; Hahn, Youn-Soo; Hong, Jong Myeon; Lee, Ok-Jun; Han, Heon-Seok (2012). "Tuberculous Pericarditis Presenting as Multiple Free Floating Masses in Pericardial Effusion". Journal of Korean Medical Science. 27 (3): 325. doi:10.3346/jkms.2012.27.3.325. ISSN 1011-8934.
- ↑ Aydin, Seniz Ongoren; Eskazan, Ahmet Emre; Aki, Hilal; Ozguroglu, Mustafa; Baslar, Zafer; Soysal, Teoman (2011). "Synchronous Detection of Hairy Cell Leukemia and HIV-Negative Kaposi's Sarcoma of the Lymph Node: A Diagnostic Challenge and a Rare Coincidence". Case Reports in Oncology. 4 (3): 439–444. doi:10.1159/000331894. ISSN 1662-6575.