Liver chemistry abnormalities and leg oedema in rheumatoid arthritis

BMJ Case Rep. 2018 Apr 19:2018:bcr2017223206. doi: 10.1136/bcr-2017-223206.

Abstract

A 66-year-old man with seronegative, erosive rheumatoid arthritis for 12 years presented with malaise, elevated alkaline phosphatase and gamma-glutamyl transferase, and leg oedema. He subsequently developed ascites. No liver pathology was found, but cardiac analysis including right heart catheterisation revealed constrictive pericarditis. Rheumatoid constrictive pericarditis is a rare condition, but, despite current effective treatment for rheumatoid arthritis, still occurs. Diagnostic delay is frequent. Although mortality of the intervention is high, pericardiectomy is needed for most patients.

Keywords: pericardial disease; rheumatoid arthritis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Alkaline Phosphatase / blood*
  • Arthritis, Rheumatoid* / blood
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / diagnosis
  • Arthritis, Rheumatoid* / physiopathology
  • Ascites / diagnosis
  • Ascites / etiology
  • Cardiac Catheterization / methods
  • Delayed Diagnosis / prevention & control
  • Diagnosis, Differential
  • Edema* / diagnosis
  • Edema* / etiology
  • Humans
  • Leg*
  • Male
  • Pericardiectomy / methods*
  • Pericarditis, Constrictive* / diagnosis
  • Pericarditis, Constrictive* / etiology
  • Treatment Outcome
  • gamma-Glutamyltransferase / blood*

Substances

  • gamma-Glutamyltransferase
  • Alkaline Phosphatase