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IgG4-related disease also needs to be ruled out before pericarditis is deemed to be idiopathic
  1. Oscar Jolobe
  1. Medical Division, Manchester Medical Society, Manchester M13 9PL, UK
  1. Correspondence to Oscar Jolobe, Manchester Medical Society, Manchester M13 9PS, UK; oscarjolobe{at}yahoo.co.uk

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To the Editor No account of idiopathic large pericardial effusions1 would be complete without mention of the requirement to rule out IgG4-related disease (IgG4-RD) as a possible underlying cause.2 3 IgG4-RD was the underlying cause of cardiac tamponade in a 60-year-old woman in whom pericardiocentesis yielded 635 mL of pericardial fluid. Chest CT also showed ‘significant’ pericardial thickening. Pericardial biopsy showed massive infiltration by lymphocytes and IgG4-positive plasma cells. Following …

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