Diagnostic Tests for Rhabdomyolysis and Pericarditis

Laboratory Tests

• The European Society of Cardiology recommends C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as markers of inflammation for diagnosing pericarditis, with complete blood count with differential to assess for infection or inflammation 1, 2
• Cardiac biomarkers, including troponins and CK, are used to detect myocardial involvement in pericarditis, with renal function tests to evaluate kidney function and liver function tests to assess for systemic involvement 1, 3
• For suspected autoimmune pericarditis, additional tests such as ANA, ENA, ANCA, and ferritin (if Still's disease suspected) are recommended, while for suspected tuberculous pericarditis, IGRA test (Quantiferon, ELISpot) is suggested 4
• The European Heart Journal guidelines suggest that for suspected viral pericarditis, PCR for viral genomes and serology for HCV and HIV should be performed, and for suspected bacterial pericarditis, blood cultures before antibiotic administration are necessary 4
• In cases of pericarditis, cardiac biomarkers may be elevated due to associated myocarditis rather than primary pericardial disease, and normal inflammatory markers do not exclude pericarditis, especially if the patient is already on anti-inflammatory treatment 1, 6

Diagnostic Algorithm

• For pericarditis, the initial laboratory panel should include CRP and ESR, complete blood count with differential, cardiac biomarkers (troponins, CK), renal and liver function tests, and thyroid function tests, with additional testing based on clinical features 1, 2, 3, 4, 5