alopecia areata and pericarditis combined?

Question

adult male 40 year old had alopecia areata for six months now.
lethargy and some joint pain in hands a few weeks ago.
today admitted and undertreatment for viral pericarditis.
I am suspecting autoimmune cause of pericarditis.

any doctors or patients have knowledge to share about hsitory prognosis and treatment for it?

He is under treatment with Indomethecin. Diagonosed as viral pericarditis. Today is third day still have some pain. There is no joint pain or inflamation. I am more concerned about the future recurrence of any other autoimmune diseases. He had history of colitis years ago.

Thanks for listening to me.
Yesterday the patient went to emergency for feeling of nausea and headache and vomitting. He had ringing in his ears for two days and felt so sick. Indomethacin 50 mg tds for five days finished and was reduced to 25 mg that morning. At the emergency the doctor tested CT scan and also did a series of blodd test for any inflammation and infection going on. Negative and the disgnosis was drug reaction to Indomethacin. Patient is feeling better but still very weak today. (Touch wood) he is on recovery now. Thanks!

I did told the emergency doctor about his old history of autoimmune disorder. He said his blood tests would cover it. Thanks !

Answer 1

lostonearth - Although it would require further testing to determine for certain, you are right that the alopecia areata and episode of pericarditis could be related. Alopecia areata is widely thought to be an autoimmune condition, and while it does sometimes occur in isolation, other autoimmune conditions called the collagen vascular diseases (like rheumatoid arthritis, lupus, scleroderma, dermatomyositis, polyarteritis nodosa) have been found in 0.6-2% of patients with alopecia areata. As it turns out, just about all of these collagen vascular diseases can also lead to pericarditis!

To know if any of these might explain your condition, a physician would need to get a full history, do a complete exam, and may send some special blood tests. If you haven't been seen by a rheumatologist, I would highly recommend that you ask for a referral or seek one out for yourself. Prognosis varies widely depending on what the diagnosis may be, but all of these conditions are treatable! Good luck to you! Hope that helps!

Here is an article you might want to track down:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3916476&dopt=Abstract

I see you've added some information. Even though they are calling this viral pericarditis, it is difficult to prove that the pericarditis is caused by a viral infection. It should really just be called acute pericarditis because, as you've pointed out, it could potentially be related to an autoimmune condition. Indomethacin is an anti-inflammatory medicine that is first-line treatment for pericarditis. If it doesn't seem to be helping, oral corticosteroids (like Prednisone) can be used. You now say there is no joint pain, but you said that he had joint pains in his hands before? I understand that you are more concerned about the risk of more autoimmune problems in the future. Nobody can tell you what the risk is or try to prevent a future event unless we know what the underlying problem is. He NEEDS to undergo a rheumatologic workup by his doctor. If he is in the hospital, I hope you are sharing your concerns with the doctor that is taking care of him right now!