Hemorrhagic Pericarditis as a Harbinger of Giant Cell Arteritis Relapse

Rohanti Ravikulan; Rupini Raja; Jasmine Chan; Muditha Jeyaweera; Vijay Turaka; Mihir D. Wechalekar; Joanne Eng-Frost

doi:10.1016/j.jaccas.2025.104627

Hemorrhagic Pericarditis as a Harbinger of Giant Cell Arteritis Relapse

Rohanti Ravikulan, Rupini Raja, Jasmine Chan, Muditha Jeyaweera, Vijay Turaka, Mihir D. Wechalekar, Joanne Eng-Frost

College of Medicine and Public Health

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Abstract

Background: Pericarditis in patients with giant cell arteritis (GCA) has been described in literature but is infrequently recognised as an initial manifestation, posing diagnostic challenges.

Case summary: A 71-year-old male presented with pericarditis as the sole clinical manifestation on a background of previously treated GCA. Despite the absence of hallmark symptoms, he was confirmed to have medium-vessel vasculitis on a fluorodeoxyglucose-positron emission tomography scan.

Discussion: This case highlights the importance of considering pericarditis and pericardial effusions as potential manifestations of GCA even in the absence of typical symptoms to ensure timely management and minimize complications and underscores the need for further data on treatment specific to GCA-related pericarditis.

Take-Home Messages: Pericarditis may be an atypical presenting symptom of GCA, occurring in the absence of typical symptoms. At present, there are limited data on the treatment of GCA-related pericarditis despite its recognition as a manifestation of the disease.

Original language	English
Article number	104627
Number of pages	6
Journal	JACC: Case Reports
Volume	30
Issue number	22
DOIs	https://doi.org/10.1016/j.jaccas.2025.104627
Publication status	Published - 6 Aug 2025

Keywords

effusion
giant cell arteritis
hemorrhagic
pericardial disease
pericardial effusion
pericarditis
vasculitis

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title = "Hemorrhagic Pericarditis as a Harbinger of Giant Cell Arteritis Relapse",

abstract = "Background: Pericarditis in patients with giant cell arteritis (GCA) has been described in literature but is infrequently recognised as an initial manifestation, posing diagnostic challenges. Case summary: A 71-year-old male presented with pericarditis as the sole clinical manifestation on a background of previously treated GCA. Despite the absence of hallmark symptoms, he was confirmed to have medium-vessel vasculitis on a fluorodeoxyglucose-positron emission tomography scan. Discussion: This case highlights the importance of considering pericarditis and pericardial effusions as potential manifestations of GCA even in the absence of typical symptoms to ensure timely management and minimize complications and underscores the need for further data on treatment specific to GCA-related pericarditis. Take-Home Messages: Pericarditis may be an atypical presenting symptom of GCA, occurring in the absence of typical symptoms. At present, there are limited data on the treatment of GCA-related pericarditis despite its recognition as a manifestation of the disease.",

keywords = "effusion, giant cell arteritis, hemorrhagic, pericardial disease, pericardial effusion, pericarditis, vasculitis",

author = "Rohanti Ravikulan and Rupini Raja and Jasmine Chan and Muditha Jeyaweera and Vijay Turaka and Wechalekar, {Mihir D.} and Joanne Eng-Frost",

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doi = "10.1016/j.jaccas.2025.104627",

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AU - Ravikulan, Rohanti

AU - Raja, Rupini

AU - Chan, Jasmine

AU - Jeyaweera, Muditha

AU - Turaka, Vijay

AU - Wechalekar, Mihir D.

AU - Eng-Frost, Joanne

PY - 2025/8/6

Y1 - 2025/8/6

N2 - Background: Pericarditis in patients with giant cell arteritis (GCA) has been described in literature but is infrequently recognised as an initial manifestation, posing diagnostic challenges. Case summary: A 71-year-old male presented with pericarditis as the sole clinical manifestation on a background of previously treated GCA. Despite the absence of hallmark symptoms, he was confirmed to have medium-vessel vasculitis on a fluorodeoxyglucose-positron emission tomography scan. Discussion: This case highlights the importance of considering pericarditis and pericardial effusions as potential manifestations of GCA even in the absence of typical symptoms to ensure timely management and minimize complications and underscores the need for further data on treatment specific to GCA-related pericarditis. Take-Home Messages: Pericarditis may be an atypical presenting symptom of GCA, occurring in the absence of typical symptoms. At present, there are limited data on the treatment of GCA-related pericarditis despite its recognition as a manifestation of the disease.

AB - Background: Pericarditis in patients with giant cell arteritis (GCA) has been described in literature but is infrequently recognised as an initial manifestation, posing diagnostic challenges. Case summary: A 71-year-old male presented with pericarditis as the sole clinical manifestation on a background of previously treated GCA. Despite the absence of hallmark symptoms, he was confirmed to have medium-vessel vasculitis on a fluorodeoxyglucose-positron emission tomography scan. Discussion: This case highlights the importance of considering pericarditis and pericardial effusions as potential manifestations of GCA even in the absence of typical symptoms to ensure timely management and minimize complications and underscores the need for further data on treatment specific to GCA-related pericarditis. Take-Home Messages: Pericarditis may be an atypical presenting symptom of GCA, occurring in the absence of typical symptoms. At present, there are limited data on the treatment of GCA-related pericarditis despite its recognition as a manifestation of the disease.

KW - effusion

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KW - pericardial effusion

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Hemorrhagic Pericarditis as a Harbinger of Giant Cell Arteritis Relapse

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