Pleuropericardial Compromise Associated With Graves’ Disease: A Systematic Review

Jose Luis Paz-Ibarra, Diego Enrique Sueldo-Espinoza, Ronald Vicente Concha-Tamo, Vladimir Zamame-Ramirez, Victor Velasquez-Rimachi, Marcio Jose Concepcion-Zavaleta

Abstract


Graves’ disease (GD) is the main cause of hyperthyroidism. Cardiovascular complications of GD may have a delayed onset, accompanied by pericardial and pleural inflammation or inflammatory effusions. Pleuropericardial compromise (PPC) associated with GD is a rare disorder. It is postulated that the pathophysiology may involve an interaction between antithyroid antibodies and pericardium. Currently, there is no guideline for the treatment of GD-induced serositis. We conducted a systematic review to compare similar PPCs in GD reports. This article aimed to summarize the information to understand physiopathology and propose preliminary management. A total of 14 articles describing 16 cases of serositis induced by GD were selected. The characteristics of the pleural and pericardial fluid express the inflammatory nature of GD and facilitate the diagnosis. Imaging methods, mainly ultrasound (US), chest X-ray, and computed tomography (CT), contribute to the diagnosis of PPC. Treatment of GD could be the cornerstone in the management of this entity, adding radioactive iodine as a definitive therapy if the patient does not reach a euthyroid state with antithyroid drugs.




J Endocrinol Metab. 2022;12(1):1-9
doi: https://doi.org/10.14740/jem790

Keywords


Graves’ disease; Pleurisy; Pericarditis; Antithyroid agents

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