Cardiac Tamponade as a Rare Initial Manifestation of Systemic Lupus Erythematosus
Abstract
Systemic lupus erythematosus is a collagen disease that frequently involves the cardiovascular system, the pericardium being the most commonly affected site. This involvement is usually pericardial effusion, majority of the time of mild degree. In a few patients, pericardial involvement may be the initial presentation of systemic lupus erythematosus. Cardiac tamponade is a rare clinical manifestation and very few cases are reported as the initial manifestation of the disease. Here, we report a patient with SLE with cardiac tamponade. Our patient presented with subacute presentation. Echocardiography showed large pericardial effusion with features suggestive of cardiac tamponade. Pericardiocentesis was done. The fluid was hemorrhagic in nature. Fluid analysis was suggestive of exudative effusion. Antinuclear antibody, U1-nRNP, nucleosomes, Sm were found to be positive. Oral prednisolone was started and slowly tapered to a maintenance dose. Azathioprine, hydroxychloroquine, torsemide were added. Patient has responded well and is following up in the OPD.
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