Recurrent pericarditis is a rare disease in childhood. Nevertheless, it may 
represent a challenge to the clinician due to its resistance to 
anti-inflammatory treatment. The initial etiology often remains unclear; 
specific laboratory parameters predicting the frequency or severity of the 
recurrences are lacking. We report on four patients with recurrent pericarditis 
in whom antimyolemmal antibodies (AMLAs) were detected. A prolonged persistence 
of IgM-type AMLAs was found in three patients: two of them presented with acute 
inflammation as the initial event and one with 48 recurrences during 5.5 years. 
The fourth patient showed a fast conversion from IgM to IgG-type AMLAs after a 
less acute initial presentation and showed 4 mild recurrences during the 
48-month follow-up.
CONCLUSION: We were able to detect AMLAs in four children with recurrent 
pericarditis. This finding may be attributed to an auto-immunological disease 
following a first, acute event. We propose the detection of AMLAs in all 
children with unexplained recurrent pericarditis. Pediatric patients with a 
persistence of IgM-type AMLAs may face frequent recurrences and should be 
monitored therefore more closely. In addition, medical treatment may be changed 
in these patients with a slower tapering of the dosage of steroidal and 
non-steroidal antiinflammatory drugs.