Idiopathic Recurrent Pericarditis

Idiopathic recurrent pericarditis (IRP) is a subset of pericarditis characterized by frequent true recurrences (free interval between two flares longer than 4 weeks). The term “idiopathic” refers to a non-specific etiology and is used even if an autoinflammatory pathway is suspected. The diagnosis is based on the association of typical symptoms and signs (mainly pericardial chest pain plus pericardial rub or electrocardiographic alterations or pericardial effusion). The monitoring of inflammatory markers and the use of imaging techniques help to guide management. Standard treatment includes the combination of non-steroidal anti-inflammatory drugs (NSAIDs) plus colchicine. In cases that do not respond to this combination, therapy with interleukin-1 inhibition has been remarkably effective.