Overlooked constrictive pericarditis as a cause of relapsing ascites and impairment of renal allograft function.

Herein we have presented a case of overlooked relapsing constrictive pericarditis with ascites in a renal transplant patient. The first symptoms of constriction appeared during hemodialysis. After a 2-year period of remission, they relapsed at 1 year after transplantation causing deterioration of renal function. We noted that constrictive pericarditis can be misdiagnosed due to symptoms characteristic of heart failure. The diagnosis should be evident from right heart catheterization and computed tomographic (CT) imaging of the thickness or calcification of the pericardium. Once the diagnosis was established surgical treatment allowed total recovery with improved graft function.