Pleuropericardial Compromise Associated With Graves’ Disease: A Systematic Review

Abstract

Graves’ disease (GD) is the main cause of hyperthyroidism. Cardiovascular complications of GD may have a delayed onset, accompanied by pericardial and pleural inflammation or inflammatory effusions. Pleuro-pericardial compromise (PPC) associated with GD is a rare disorder. It is postulated that the pathophysiology may involve an interaction between antithyroid antibodies and pericardium. Currently, there is no guideline for the treatment of GD-induced serositis. We conducted a systematic review to compare similar PPCs in GD reports. This article aimed to summarize the information to understand physiopathology and propose preliminary management. A total of 14 articles describing 16 cases of serositis induced by GD were selected. The characteristics of the pleu-ral and pericardial fluid express the inflammatory nature of GD and fa-cilitate the diagnosis. Imaging methods, mainly ultrasound (US), chest X-ray, and computed tomography (CT), contribute to the diagnosis of PPC. Treatment of GD could be the cornerstone in the management of this entity, adding radioactive iodine as a definitive therapy if the patient does not reach a euthyroid state with antithyroid drugs.