Concise reports
Pericardial involvement in systemic sclerosis
a Department of Pathological Sciences, The
University of Manchester, Manchester , b Department of Rheumatology, Inverclyde Royal
Hospital, Greenock
Correspondence to: Dr R J Byers, Department of Histopathology, Clinical Sciences Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.
Accepted for publication 19 March 1997
OBJECTIVE
To determine the frequency and
histological characteristics of pericardial involvement in systemic sclerosis.
METHODNecropsy sections of pericardium from 44 patients with systemic sclerosis were studied, together with sections
from 19 age/sex matched controls. Sections were stained with
haematoxylin and eosin, acid toluidine blue, and elastic van Gieson.
Mast cells were counted in 10 random high power fields and the degree
of fibrosis was quantified using a Chalkley count.
RESULTSChronic pericarditis was seen in 31 (77.5%) of the systemic sclerosis cases, but in only one of the
controls. The characteristic changes of uraemic pericarditis were not
seen. The degree of fibrosis was greater in those with systemic
sclerosis, though numbers of mast cells, thought to be important in
fibrogenesis, were similar in both groups. Myocardial fibrosis was seen
in 15 (37.5%) of systemic sclerosis cases but in none of the controls.
CONCLUSIONThe incidence of pericarditis and
myocardial fibrosis is much greater than in controls. The results
indicate that pericarditis is a primary disease (rather than secondary
to uraemia).
© 1997 by Annals of the Rheumatic Diseases
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