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Case Reports in Rheumatology
Volume 2016 (2016), Article ID 2576496, 3 pages
Case Report

Hemorrhagic Pericardial Effusion with Tamponade: A Rare Adverse Effect of Infliximab—Case Report and Literature Review

1University of Michigan Medical School, Ann Arbor, MI, USA
2Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA

Received 14 July 2016; Accepted 28 September 2016

Academic Editor: Shigeko Inokuma

Copyright © 2016 Henry D. Lather and J. Michelle Kahlenberg. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Antitumor necrosis factor (TNF) alpha agents are commonly used biologic therapies for a wide variety of rheumatic and inflammatory diseases. Here, we present a case of hemorrhagic pericarditis as a consequence of infliximab and review the literature on pericardial complications stemming from this drug class. Methods. For the literature review, search terms using versions of antitumor necrosis factor alpha AND pericardial effusion OR pericarditis OR pleuropericarditis OR cardiac tamponade were used. Results. Pericarditis is a rare but serious complication of anti-TNF based therapy, and hemorrhagic fluid is even more rare, with only one additional case reported. It is likely that this complication was secondary to a robust immune response to very high titer anti-infliximab antibodies. Providers should be aware that this complication can occur and that abnormal elevations in procalcitonin may accompany this unusual finding.