Recurrent Pericarditis: A Manifestation of Systemic Inflammation?

Recurrent pericarditis represents one of the most challenging manifestations of pericardial diseases, due to its impact on quality of life, the prolonged use of anti-inflammatory therapies, and the risk of progression to refractoriness.^, Although classically described as an episodic condition, evidence indicates that, in a significant proportion of cases, recurrence may reflect persistent underlying systemic inflammation, often of an autoinflammatory nature, not fully captured by conventional inflammatory markers.^, In this context, recurrent pericarditis has evolved from a local approach to a systemic entity; inflammasome and interleukin-1 activation support more severe and recurrent phenotypes.^–

The Systemic Immune-Inflammation Index (SII), calculated as SII = (platelets × neutrophils)/lymphocytes, integrates central components of systemic inflammation and the immune response, reflecting the balance between innate and adaptive immunity and platelet activation.^– It differs from composite diagnostic scores, such as the INFLA-score. The SII constitutes a continuous quantitative biomarker, intended for estimating the underlying systemic inflammatory burden and for temporal monitoring of immuno-inflammatory activity.^–

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