• Angela Mauro, Emanuele Bizzi, Maddalena Alessandra Wu, Ruggiero Mascolo, Camilla Chirico, Edoardo Conte, Enrica Negro, Lisa Serati, Alice Pedroli, Chiara Carollo, Martina Sandini, Enrico Tombetti, Elisa Calabrò, Luca Bernardo, and Antonio Brucato.
• Pediatric Rheumatology Unit, Department of Childhood and Developmental Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy. angela.mauro@asst-fbf-sacco.it.
• Intern Emerg Med. 2024 Aug 20.

AbstractRecurrent pericarditis, an inflammatory syndrome with a pathogenesis not fully elucidated, often presents diagnostic challenges. This study aims to assess the correlation of D-Dimer (D-D) and procalcitonin (PCT) levels with clinical, laboratory and imaging features in recurrent idiopathic pericarditis. We analyzed 412 patients with idiopathic recurrent pericarditis from 2019 to 2023 in our referral center. D-D and PCT values were obtained from emergency room in other Italian facilities. Among the cohort, PCT levels were assessed in 50 of 412 patients (12.1%), with only 4 showing marginal elevation. D-D levels were measured in 48 of 412 patients (11.6%), with 33 of them exhibiting elevated values. None of these patients had venous thromboembolism, and elevated D-D levels were significantly associated with pleural effusion, fever, higher CRP, increased white blood cell counts, higher neutrophil counts, reduced relative lymphocyte counts. Multivariate analysis revealed fever as the sole correlate of elevated D-D. PCT elevation was infrequent and unrelated to any variables. In idiopathic recurrent pericarditis unrelated to specific conditions, we observed a close association between elevated D-D levels and non-specific inflammation markers, including fever, increased CRP, and neutrophil leukocytosis. PCT levels were typically normal or mildly elevated.© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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