Pericardial effusion: I had taken Prednisone for... - PMRGCAuk

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Pericardial effusion

Tiredofpmr555 profile image
13 Replies

I had taken Prednisone for about three and a half years for PMR and stopped about four months ago. In December a follow up CT scan for something else showed fluid in the pericardial sac. One of the causes listed for this to occur is an auto immune condition.

I have never seen anyone on this forum speak of having pericardial effusion but would be interested in any incidents of such when stopping the Prednisone.

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Tiredofpmr555
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13 Replies
SheffieldJane profile image
SheffieldJane

I don’t know much about your specific question but Prednisalone does cause fluid retention I believe.

PMRpro profile image
PMRproAmbassador

pubmed.ncbi.nlm.nih.gov/211...

says it happens in various autoimmune mediated disorders and GCA actually gets a mention. It can to us. also happen for a load of other reasons. Have you had Covid or a vaccination?

my.clevelandclinic.org/heal...

says it is often found incidentally when imaging is done for something else as in your case.

In all the years I have been on the forums, I can only remember a couple of cases being identified and reported to the forum.

Are they doing anything about it?

Tiredofpmr555 profile image
Tiredofpmr555 in reply toPMRpro

I an scheduled to have a "pericardial window" cut in my chest, the fluid drained and a drain left in. I shall be in hospital two days. I don't want to have it done, but I am very short of breath, can't do much so I don't see any way out.

PMRpro profile image
PMRproAmbassador in reply toTiredofpmr555

All the best - when? Soon?

Tiredofpmr555 profile image
Tiredofpmr555 in reply toPMRpro

Thank you! I should be scheduled in a couple of weeks.

I was trying, recently, to cut down on prednisone and apparently went too quickly - from 5 mg to 3.5 mg in just 4 weeks. I think my haste caused pericarditis - which had me in the hospital one day with lots of tests. After being given colchicine, they could find no inflammation. It's a gout medicine but according to WebMD is now used for pericarditis. The "clue" in the symptoms was that either lying down or leaning forward made it much worse (it certainly did) and without the colchicine, it was helped by Advil. Whether or not the thoracic scoliosis I have contributes to the heart running into the lungs (according to the cardio guy that was what was causing the pain) wasn't addressed. Neither was the cause of the inflammation. To his credit, when I explained the sudden drop in pred after 3 years, he at first said he didn't think that would cause it. When I explained about this forum and the caution about tapering very slowly, he admitted that he didn't know much about it - and that maybe I was right. It was, at least, an explanation. Then he went on to talk about his chickens! Fun day in the hospital!!

PMRpro profile image
PMRproAmbassador in reply to

WE would say that was at the very least 3 times too fast!! 1/2mg in 4 weeks is pushing it in our book!

I would be doubtful that the speed of reduction itself directly CAUSED the pericarditis but the most common cause is viral. If you had caught something and at the same time dropped the pred dose that quickly your adrenal function would be struggling and you might not fight off the virus very effectively so it went off looking for a weak point. Autoimmune disorders also predispose you to pericarditis though PMR doesn't figure high on the list, RA and lupus are more likely.

in reply toPMRpro

Thanks, Pro - the only problem is no virus, certainly none that I was aware of nor do I have RA or Lupus - are either idiopathic peripheral neuropathy or celiac considered auto immune?

PMRpro profile image
PMRproAmbassador in reply to

No, one often isn't. especially with Covid, it is very sneaky these days! Coeliac is also an autoimmune condition and idiopathic PN may possibly be due to an autoimmune condition including vasculitis. And there is lots to find out about it.

winfong profile image
winfong

I just got diagnosed with a pericardial effusion. I've also got a dilated aortic root. Both may be minor. Seeing my cardiologist Monday to hash it all out. We shall see. I'll post here. BTW, I'm PMR/GCA/LVV. And no real changes in meds.

Also, what were your symptoms? I had fatigue (more than normal), a cough, breathlessness on exertion, edema in my ankles.

Tiredofpmr555 profile image
Tiredofpmr555 in reply towinfong

Just shortness of breath and a dull feeling in the chest. I also have no energy. I sleep for at least an hour every afternoon.

PMRpro profile image
PMRproAmbassador in reply toTiredofpmr555

Had you had a Covid vaccination before it started? Just wondered, as a German study found it wasn't only in young men such a reaction was found - our age group too. I had arrythmia problems after the bivalent jab 15 months ago but they were never looked at closely at the time as I had a history of atrial fibrillation anyway and it was assumed that the medication stopped working as it is known to do. But why it would stop so suddenly is beyond me - I went from fine to not fine in a few hours.

Tiredofpmr555 profile image
Tiredofpmr555 in reply toPMRpro

I have had three vaccinations total but none in the past year.

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