Cholesterol Pericarditis

This image-based case report describes a 64-year-old man with well-controlled rheumatoid arthritis who presented with fatigue and pleuritic abdominal pain. Imaging unexpectedly revealed a large pericardial effusion, confirmed by echocardiography. Pericardiocentesis yielded 960 ml of yellow, cloudy fluid. Analysis showed elevated lactate dehydrogenase (1056 IU/L) and leukocytosis (2992/mm³), with microscopy revealing cholesterol crystals and foamy histiocytes. These findings led to a diagnosis of cholesterol pericarditis, a rare condition characterized by chronic pericardial effusion rich in cholesterol, often associated with rheumatoid arthritis. Treatment with colchicine was initiated, and no recurrence of effusion was noted during hospitalization or on follow-up echocardiography 3 months later.

This image-based case report describes a 64-year-old man with well-controlled rheumatoid arthritis who presented with fatigue and pleuritic abdominal pain. Imaging unexpectedly revealed a large pericardial effusion, confirmed by echocardiography. Pericardiocentesis yielded 960 ml of yellow, cloudy fluid. Analysis showed elevated lactate dehydrogenase (1056 IU/L) and leukocytosis (2992/mm³), with microscopy revealing cholesterol crystals and foamy histiocytes. These findings led to a diagnosis of cholesterol pericarditis, a rare condition characterized by chronic pericardial effusion rich in cholesterol, often associated with rheumatoid arthritis. Treatment with colchicine was initiated, and no recurrence of effusion was noted during hospitalization or on follow-up echocardiography 3 months later.