adequada ao corticosteroide, pode-se associar azatioprina ou ciclosporina 206 . Um dos principais fatores determinantes da recorrência é a redução rápida da dose de corticoide, que não deve ser feita num período inferior a três meses. A pericardiectomia está indicada para os casos com recorrência frequente, muito sintomática e refratária à terapêutica 333-335 . A tabela 37 resume as indicações para o tratamento na pericardite recorrente. I Diretriz Brasileira de Miocardites e Pericardites Diretrizes Tabela 37 – Indicações para o tratamento da pericardite recorrente. Classe de recomendação Classe I Classe IIa Classe IIa Classe IIb Classe IIb Classe IIb Indicações Colchicina por 6 meses no tratamento da pericardite recorrente Asprina ou ibuprofeno para o tratamento da pericardite recorrente Colchicina para o tratamento de pericardite pós infarto agudo do miocárdio Pericardiectomia no tratamento de pericardite recorrente para casos refratários e muito sintomáticos Corticosteroides sistêmicos no tratamento da pericardite recorrente após falha no tratamento com AINEs e colchicina Utilização de outros agentes imunossupressores (azatioprina e ciclosporina) nas recorrências por doenças auto-imunes ou do colágeno Nível de evidência Arq Bras Cardiol: 2013; 100(4 Supl. 1): 1-36 B B B B C C 27
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