A Case of Uremic Pericarditis and Cardiac Tamponade That Developed after Ethylene Glycol Poisoning: A Case Report / 대한구급학회지

Ethylene glycol is commonly incorporated into automotive antifreeze agents and a variety of other commercial products. Ethylene glycol poisoning can cause life-threatening metabolic acidosis, cardiopulmonary failure, and renal failure that may be fatal. We present an unusual case of a patient who ingested a large amount of ethylene glycol for the purpose of suicide and developed multiorgan damage, including acute renal failure followed by uremic pericarditis and cardiac tamponade. This unusual complication was effectively managed with echocardiography-guided percutaneous pericardiocentesis and continuous catheter drainage for 3 days. After intensive hemodialysis and supportive care, the patient made a good recovery with near normal cardiac and renal function. Physicians should be aware of the possibility of acute pericarditis and cardiac tamponade in cases of acute renal failure caused by ethylene glycol poisoning.

The Characteristics and Related Factors with Severe Uremic Pericarditis / 대한신장학회잡지

BACKGOUND: Although the incidence has decreased markedly, mortality from uremic pericarditis still remained high at 8-10% due to hemodynamic compromise. Moreover, it is difficult to diagnose and discriminate from other causes of pericarditis such as tuberculous pericarditis in its early stage. The aim of this study was to analyze the factors that were related to the development of uremic pericarditis and factors that could distinguish it from other causes of pericarditis. METHODS: Eighteen patients who received pericardiocentesis due to uremic pericarditis from 1996 to 2005 in Korea university hospital were enrolled. All patients were diagnosed as severe uremic pericarditis by echocardiography. And as a comparison group, 37 patients with tuberculous pericarditis and 20 patients with malignant pericarditis were also enrolled. Analysis of the factors that were related to the development of uremic pericarditis or comparison of clinical, biochemical factors in uremic, tuberculous or malignant pericarditis were also done. RESULTS: In uremic pericarditis, the proportion of patients with peritoneal dialysis was higher (55.6%). The amount of pericardial effusion showed a positive correlation with the duration of dialysis, whereas showed negative correlation with hemoglobin and cholesterol levels. Pericardial fluid ADA was significantly higher in tuberculous pericarditis and pericardial fluid glucose was higher in uremic pericarditis. No specific factors that were related to the development of pericardial tamponade were identified. CONCLUSION: The development of severe uremic pericarditis might be related to poor nutritional status. In the early stage, ADA and glucose levels in pericardial fluid could be useful in distinguishing uremic pericarditis from tuberculous pericarditis. Prospective studies that enroll large patient population can be helpful in identifying factors that are related to the development of uremic pericarditis or tamponade.