Pericarditis
Thalassemia patients are susceptible to benign pericarditis, possibly
caused by viral and mycoplasmal organisms, bacterial or fungal
infections, or associated with the engraftment syndrome in posttransplantation
thalassemic patients.30 “Iron-induced” pericardial
siderosis has also been postulated as a causative factor.31 Diagnosis
is made by history and physical signs and is confirmed with serial
electrocardiograms and chest x-ray and requires hospitalization if
they are symptomatic. Pericarditis is best managed with bed rest
and aspirin. Steroids may be helpful with engraftment syndrome
and iron chelation with hemosiderosis. When a significantly large
pericardial effusion is present, the patient should be hospitalized
and observed. Pericardiocentesis and diuretics are recommended to
prevent cardiac tamponade.32 Surgical intervention may be necessary
if significant pericardial effusions recur.