[Idiopathic PN]

As I may have mentioned in the past, other than my lung problems, I am also having GI problems (bloating and spasm).

I had a cat scan of my abdomen early this month. The good news is there are no abnormalities in my addomen (thank God). There was something that was captured in the scan. The report says:

"There is a fluid filled mass inseparable from the right epicardial fat pad/right cardiophrenic angle. A pericardial cyst or loculated percardial effusion are the most likey considerations."

My GI doctor said report to be referred to my pulmo doctor.
The pulmo doctor said it should be referred to my cardio.
Now, I am waiting for the feedback from my cardio.

I mentioned this report to my neuro this afternoon, and he said that I should refer it to my rheumatologist because there are pericardial effusions that are caused by connective tissue disease. I will have to fax the report to my rheumy tomorrow.

I know this maybe an unlikely case in this forum but I would be interested if anybody has/had similar condition.

Thank you.

[mrsD]

I believe the most common cause is infectious, followed by autoimmune.

Here is a link:
http://en.wikipedia.org/wiki/Pericardial_effusion

One of my son's teachers in high school, continued exercise while he had a virus and developed this severely, and almost died as a result. Otherwise healthy, and only 42 yrs old.

There are mild forms and acute forms. That is basically all I know about it, as one really needs a doctor to carefully follow you if you show effusion tendencies.

[Idiopathic PN]

Originally Posted by mrsD

I believe the most common cause is infectious, followed by autoimmune.

Here is a link:
http://en.wikipedia.org/wiki/Pericardial_effusion

One of my son's teachers in high school, continued exercise while he had a virus and developed this severely, and almost died as a result. Otherwise healthy, and only 42 yrs old.

There are mild forms and acute forms. That is basically all I know about it, as one really needs a doctor to carefully follow you if you show effusion tendencies.

I provided a copy of this report to my cardio. I am waiting for his feedback on what to do next. I had a Thoracic Echocardiogram last August and this fluid mass did not show.

Thank you Mrs.D.

[davidl]

I, too, was discovered to have a pericardial effusion several months ago. Was ultimately also sent to a rheumatologist. The rheumatologist is suspicious of an autoimmune disease/disorder and has some evidence pointing to it such as moderately postivie ana blood reading along with some other things. She doesn't have a definitive diagnosis yet though.

My point is that I have also had a pericardial effusion.

[Idiopathic PN]

Originally Posted by davidl

I, too, was discovered to have a pericardial effusion several months ago. Was ultimately also sent to a rheumatologist. The rheumatologist is suspicious of an autoimmune disease/disorder and has some evidence pointing to it such as moderately postivie ana blood reading along with some other things. She doesn't have a definitive diagnosis yet though.

My point is that I have also had a pericardial effusion.

Thank you for your reply.

What did they do with your effusion? Do you have shortness of breath? Any medications for it or is it a "wait and see" plan?

Please let me know.

[davidl]

The only thing that has been done so far since the effusion was discovered was that I was briefly put on plaquenil. However, the rheumatologist has pulled me off of it for the time being because she is concerned that it is driving my white blood cell count down. Me, personally, I think it's more likely that whatever is going on autoimmune related is what's driving the white blood cell count down. At any rate, the only thing that has been done since the discovery of the effusion was the trial of plaquenil. So I guess it's been more of a wait and see approach.

As far as shortness of breath, I haven't noticed too much. I haven't noticed any more difficulty in taking my walks. What I have had lately is some chest pain around or near my heart that I think is something going on with the auto-inflammatory process. Perhaps it is the pericardial effusion I'm feeling.

[mrsD]

It is just as well you are off the Plaquenil... this drug has been implicated in causing PN in some patients.

[Marlene]

John had both pericardial and plural effusions. He was in a bad way at the time but they did not intervene until they were really bad. He was in the hospital at the time for treatment for aplastic anemia. They did have him on a diuretic though to help offload the fluid. Most resolve on their own as the patient's health improves.

When they did drain them, they checked the fluid for bacterial and viral infections but found none.

[davidl]

Marlene, if you don't mind me asking, I was curious as to how he was treated for the aplastic anemia? Thanks.

I'm going to a hematologist in about a week relating to my white blood cell counts trending downward and I was just wondering more about this.

[Marlene]

John was treated in 2002 at Johns Hopkins. He participated in a clinical trial for High Dose Cytoxan. It's high doses of the drug for 4 days which basically wipes out your immune system. There are blood stem cells that are not effected which then re-populate the bone marrow. The other two treatments are a bone marrow transplant or immunosuppressant therapy with ATG and Cyclosporine.

It's not treated until it is considered to be severe.

If you are on any drugs, they can impact your blood counts. Statins and anti-biotics can effect blood counts. Also, make sure, if you haven't already, have your B12, folate, iron, vit D, copper and zinc checked. These are the key nutrients for blood production. One other thing. H-Pylori, the bacteria which causes ulcers, can also effect your bone marrow. So get them to test you for that also. You may not have an ulcer, but still have the bug. These are the easy things to rule out up front.