A further study has shown that the patients who proceeded traditional open operations of pericardiectomy had a perioperative morbidity and mortality as high as 21%. Barcin et al have suggested the effusion tended to recur and instances pericardiocentesis only provided temporary relief. But the therapeutic effect of these drugs in CP was not effective. It has been reported that acetylsalicylic acid, nonsteroidal anti-inflammatory drugs, corticosteroids, colchicine, and immunosuppressive drugs were used in the treatment of idiopathic pericarditis. CP was one of the idiopathic pericarditis. The surgical pathology has shown a fibrously thickened pericardium with cholesterol crystals, which further approved the diagnosis. A faint yellow appearance and many cholesterol crystals were shown in our case, and it could be a diagnostic basis of CP. According to previous history and the augment of C-reactive protein, rheumatoid factor, anticyclic citrullinated peptide antibody in the patient's blood, the patient was in an active stage of rheumatoid arthritis. One possible mechanism is supposed to be the release of cholesterol from pericardial cell membranes or from necrotic rheumatoid nodules. Rheumatoid arthritis has been suspected to be associated with CP. However, our patient had no symptoms above. Many studies have shown that patients who suffered CP presented with dyspnea, chest pain, dizziness, fatigue, or shortness of breath. CP, which was first reported in a case of pericardial effusion of gold paint appearance in 1919, was a special rare type of pericarditis characterized by chronic pericardial effusion with high cholesterol concentration, with or without the formation of crystals. It has been reported that pericarditis was associated with infectious, such as viral, bacterial and tuberculosis, and noninfectious, such as systemic vasculitis, hypothyroidism, cancer and postcardiac injury syndromes. Pericarditis was the most common form of pericardial disease worldwide.
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