Intrapericardial Triamcinolone Instillation for Recurrent Pericardial Effusion in Pediatric Patients: A Review of Efficacy and Safety

Intrapericardial administration of the glucocorticoid medication triamcinolone is reported useful in the treatment of recurrent pericardial effusion in adult patients. Nevertheless, the studies on triamcinolone use in pediatric patients are scarce, and the effectiveness and side effect profile of intrapericardial triamcinolone in children is not well characterized. This single center retrospective case series seeks to expand on the efficacy, side effects, and safety of intrapericardial triamcinolone in pediatric patients suffering from recurrent idiopathic pericardial effusions. Nine pediatric patients who received intrapericardial triamcinolone for recurrent idiopathic pericardial effusion at a single center from 2015 to 2025 were included. The pericardial effusion progression was observed with serial echocardiograms and new symptoms appeared after triamcinolone administration. Five patients demonstrated resolution of pericardial effusion, three had improvement, and one relapsed after intrapericardial triamcinolone administration. Five patients suffered from short-term steroid-like side effects that resolved prior to discharge, and two died of underlying disease rather than treatment with triamcinolone. These findings are consistent with the idea that intrapericardial triamcinolone can be utilized as a safe and effective adjunctive treatment option in children with recurrent idiopathic pericardial effusion.