A patient has a fourth episode of idiopathic pericarditis despite adherent colchicine. Each attempt to reduce prednisolone below 10 mg triggers a

Question

A patient has a fourth episode of idiopathic pericarditis despite adherent colchicine. Each attempt to reduce prednisolone below 10 mg triggers a CRP-positive relapse, CMR still shows pericardial inflammation, and infection, malignancy and systemic autoimmune disease have been excluded. Which steroid-sparing strategy best fits this phenotype?

Accepted Answer

Refer for interleukin-1 blockade with a specialist corticosteroid-tapering plan

Answer

Arrange pericardiectomy before attempting a cytokine-targeted steroid-sparing treatment

Answer

Add azathioprine as the preferred rapid-onset treatment for an acute inflammatory relapse

Answer

Use intravenous immunoglobulin before considering targeted therapy for recurrent autoinflammation

Answer

Continue prednisolone 10 mg indefinitely because objective inflammation makes tapering unnecessary

Aortic Root Abscess with Conduction Disease — EECC MCQ