14 April 2025
: Case report 
Chronic Appendicitis-Induced Effusive-Constrictive Pericarditis and Hepatic Fibrosis: A Case Report
Unusual clinical course, Challenging differential diagnosis, Rare coexistence of disease or pathology
Jacek Kołcz
1AE*, Mirosława Dudyńska1BF, Maria Dzierzenga 2BD
DOI: 10.12659/AJCR.947326
Am J Case Rep 2025; 26:e947326
Table 1. Longitudinal laboratory data demonstrating the chronic evolution of effusive-constrictive pericarditis and systemic inflammation.
| Parameter | Reference range | At admission (Day 0) | Post-pericardiocentesis (Day 3) | Pre-pericardiectomy (Day 14) | Post-pericardiectomy (Day 16) | Pre-appendectomy (Week 8, Day 58) | Post-appendectomy (Week 9, Day 65) | Last follow-up (Week 12, Day 84) |
|---|---|---|---|---|---|---|---|---|
| WBC (×10/L) | 4.0–11.0 | 15.2 | 13.8 | 12.5 | 10.2 | 14.5 | 8.5 | 6.8 |
| Neutrophils (%) | 40–70 | 82.0 | 78.0 | 74.0 | 68.0 | 80.0 | 62.0 | 55.0 |
| CRP (mg/L) | <5 | 151.0 | 132.0 | 95.0 | 65.0 | 120.0 | 28.0 | 5.0 |
| ESR (mm/hr) | 0–15 | 65.0 | 60.0 | 55.0 | 42.0 | 70.0 | 20.0 | 10.0 |
| AST (U/L) | 10–40 | 76.0 | 65.0 | 58.0 | 45.0 | 82.0 | 38.0 | 32.0 |
| ALT (U/L) | 10–50 | 92.0 | 85.0 | 72.0 | 58.0 | 90.0 | 45.0 | 40.0 |
| LDH (U/L) | 140–280 | 580.0 | 540.0 | 490.0 | 430.0 | 600.0 | 350.0 | 290.0 |
| Albumin (g/L) | 35–50 | 28.0 | 30.0 | 32.0 | 35.0 | 30.0 | 40.0 | 42.0 |
| Total bilirubin (µmol/L) | 3–17 | 19.0 | 18.0 | 16.0 | 14.0 | 22.0 | 12.0 | 10.0 |
| D-dimer (ng/mL) | <500 | 2200.0 | 1800.0 | 1300.0 | 900.0 | 2500.0 | 600.0 | 500.0 |
| Fibrinogen (g/L) | 2–4.5 | 7.2 | 6.5 | 5.8 | 4.9 | 7.8 | 3.9 | 3.6 |
| WBC – white blood cell count; CRP – C-reactive protein; ESR – erythrocyte sedimentation rate; AST – aspartate aminotransferase; ALT – alanine aminotransferase; LDH – lactate dehydrogenase. | ||||||||