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A case of spontaneous purulent granulomatous pericarditis in a beagle.

ABSTRACT: The present report describes a case of spontaneous purulent granulomatous pericarditis in a 16-month-old beagle. A gross necropsy revealed pericardial effusion and multiple nodules on the surface of the heart and around the aorta adjacent to the heart. The cut surface of these nodules was solid and white in color, containing partially yellowish white regions. Microscopically, granulomatous inflammation characterized by central necrotic cellular debris surrounded by neutrophils, macrophages, lymphocytes, plasma cells, fibroblasts and collagen fibers was observed in the epicardium. In addition, degeneration or necrosis of the arterial wall with inflammation was observed in the nodules. No gross and histological findings were observed in any organs other than the heart. Bacteria and fungi were not detected by Periodic acid-Schiff staining, Gram-Hucker staining and Ziehl-Neelsen staining. Based on these findings, the dog was diagnosed as having purulent granulomatous pericarditis. Purulent pericarditis is usually caused by pyogenic bacterial or fungus infections; however, no changes indicating a possible infection were observed in this case. In cases with spontaneous vascular changes, such as idiopathic canine polyarteritis or beagle pain syndrome, epicarditis could be secondarily caused by vascular lesions. Since this case showed different pathological features from those of spontaneous vascular changes, the pathogenesis may be different and remains unclear. To the best of our knowledge, this is the first report describing purulent pericarditis in beagles. Our case report is expected to be useful information that can be used as cardiac background findings for evaluating heart lesions in preclinical toxicology studies performed in beagles.

SUBMITTER: Kamio K

PROVIDER: S-EPMC5545679 | biostudies-other | 2017 Jul

REPOSITORIES: biostudies-other

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Project description:BackgroundAcute pericarditis is frequently encountered in clinical practice; however, pericarditis as the first presentation of Graves' disease is rare and mainly limited to case reports in the literature. We hereby report a case in which a young patient presented with pericarditis as the first manifestation of Graves' disease.Case summaryA 24-year-old male was admitted to hospital with presenting complaint of left-sided chest pain, gradual in onset, 6/10 in intensity, sharp in character, increased by deep breathing and improved by leaning forward. Patient also gave a history of insomnia, unintentional weight loss despite a good appetite, heat intolerance, and anxiety. On clinical examination, the patient had features of thyrotoxicosis, i.e., tachycardia, high volume pulse, and sweaty palms with fine tremors. There was no associated pericardial rub. Neck examination shows diffuse, non-tender goitre. Electrocardiogram findings were consistent with acute pericarditis. His thyroid function tests demonstrated hyperthyroidism and anti-thyroglobulin antibodies were also significantly elevated. Echocardiogram showed preserved left ventricular systolic function and a small global pericardial effusion without any signs of tamponade. He was diagnosed with Graves' disease revealing itself as pericarditis and was started on ibuprofen, beta-blockers, and carbimazole. Patient had marked clinical and biochemical improvement on 3 monthly follow-ups.DiscussionThyro-pericarditis is a rare entity, and limited literature is available regarding this combination. The exact aetiology of Graves associated pericarditis is unknown. There is a possibility of interaction of autoantibodies with receptors on pericardium. Diagnosis is based on a detailed history, clinical examination, supplemented by relevant investigations (elevated free T4 and thyroid receptor antibodies, suppressed thyroid stimulating hormone (TSH) and Imaging via ultrasound). Mainstay of treatment includes non-steroidal anti-inflammatory drugs, beta-blockers, and anti-thyroidal medications.

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A case of spontaneous purulent granulomatous pericarditis in a beagle.

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