Which lab tests may be indicated in the diagnosis of acute pericarditis based on suspected etiology?

Updated: Apr 02, 2019
  • Author: Sean Spangler, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Further laboratory workup may be clinically indicated, as follows:

  • Blood and/or viral cultures

  • Tuberculosis skin testing and/or tuberculin sputum testing for acid-fast bacilli (AFB) can be used if the illness exceeds 1 week duration. The ESC 2004 guideline also recommends obtaining mycobacterium culture or radiometric growth detection (eg, BACTEC-460), adenosine deaminase (ADA), interferon (IFN)-gamma, and pericardial lysozyme, in addition to polymerase chain reaction (PCR) analyses of tuberculosis. [32]

  • Antistreptolysin titer

  • Rheumatoid factor (RF), antinuclear antibody (ANA), and anti-DNA values, particularly if the illness is prolonged or severe

  • Thyroid function in patients with large pericardial effusion

  • The ESC 2004 guideline on the diagnosis and management of pericardial diseases recommends pericardial fluid or pericardial or epicardial biopsy analyses to confirm diagnosis of malignant pericardial disease. The guideline states that at least 3 cultures of pericardial fluid for aerobes and anaerobes, as well as blood cultures, are mandatory in cases of suspected bacterial infection. [32]

  • Human immunodeficiency virus (HIV) testing


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