Published online Sep 26, 2020. doi: 10.4330/wjc.v12.i9.460
Peer-review started: July 2, 2020
First decision: June 20, 2020
Revised: July 2, 2020
Accepted: September 1, 2020
Article in press: September 1, 2020
Published online: September 26, 2020
Core Tip: (1) To be able to investigate the etiology of pericardial effusion and cardiac tamponade with eosinophilia which is rarely caused by eosinophilic granulomatosis polyangiitis (EGPA); (2) To be mindful that anti-neutrophil cytoplasmic antibody is negative in EGPA with cardiac involvement rather than pulmonary or renal involvement; (3) To be aware that when isolated pericardial involvement leading to cardiac tamponade occurs, diagnosis is recognized by performing pericardial biopsy demonstrating histopathologic evidence of eosinophilic infiltration; (4) To consider early diagnosis of EGPA with cardiac involvement is crucial because it carries a major burden of morbidity and mortality; (5) To initiate early treatment with corticosteroids when an isolated pericardial involvement is present whereas immunosuppressants are utilized with multiorgan involvement; and (6) To conduct close surveillance in the outpatient setting to monitor the response to treatment and maintenance medications such as steroids and monoclonal antibodies.