Abstract
In this communication we describe cholesterol pericarditis with massive effusion in a 13 year old girl who presented initially with hypertension, peripheral edema, albuminuria and hematuria. Family history was consistent with Type II hyperlipoproteinemia. On cardiac examination the heart sounds were muffled and distant. No murmur was heard. The liver was enlarged and firm. The electrocardiogram showed generalized low voltage. Chest rontgenogram revealed a large cardiac shadow. The echocardiogram suggested the presence of massive pericardial effusion. Cardiac catheterization with angiography confirmed such a diagnosis. Serum cholesterol varied from 600 to 900 mgm.% Pericardiocentesis yielded one litre of bloody fluid which did not clot on standing. The cholesterol content of the fluid was 315 mm.%. Repeated tappings were followed with rapid accumulation of the fluid. Subtotal pericardiectomy was done. The pericardium was markedly thickened and the heart was covered with a golden flaky exudate which was easily peeled off. Smear and culture of the fluid and flakes were negative for bacteria and fungi. Her blood pressure returned to normal after the pericardiectomy. The patient was placed on low cholesterol diet and cholysteramine. Cholesterol pericarditis is a rare entity and to our knowledge it has not previously been described in the pediatric age group.
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Khoury, G., Klingberg, W. CHOLESTEROL PERICARDITIS WITH EFFUSION. Pediatr Res 8, 351 (1974). https://doi.org/10.1203/00006450-197404000-00066
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DOI: https://doi.org/10.1203/00006450-197404000-00066