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32M with third episode of pericarditis in 18 months. CRP 45, ESR elevated, echo shows trace pericardial effusion. ANA, RF, anti-dsDNA negative. First two episodes resolved with NSAIDs + colchicine. Now presenting again. Should we add low-dose corticosteroids this time, or try extended colchicine course? What is the role of IL-1 blockers like anakinra in recurrent pericarditis?
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