Related Experiment Videos
Scleroderma pericardial disease presented with a large pericardial effusion--a case report
R M Gowda1, I A Khan, T J Sacchi
1Department of Medicine, Long Island College Hospital, Brooklyn, NY, USA.
Angiology
|February 24, 2001
Summary
Scleroderma often involves the pericardium, but large pericardial effusions are rare. This case highlights a patient whose large pericardial effusion preceded other scleroderma symptoms, offering new insights into this condition.
Area of Science:
- Rheumatology
- Cardiology
- Internal Medicine
Background:
- Scleroderma, a systemic autoimmune disease, commonly affects the pericardium, often asymptomatically.
- Pericardial involvement in scleroderma is frequently detected via autopsy (50%) or echocardiography (41%), but symptomatic pericarditis is less common.
- Typically, pericardial effusion in scleroderma appears after other clinical and serologic manifestations.
Observation:
- A rare case of scleroderma is presented where a large pericardial effusion was the initial clinical manifestation.
- This effusion antedated the development of other characteristic clinical and serologic features of scleroderma.
- The patient's presentation challenges the typical timeline of pericardial involvement in scleroderma.
Findings:
- Echocardiography can detect pericardial effusion in a significant portion of scleroderma patients, though usually small and asymptomatic.
- Symptomatic pericarditis occurs in 16% of diffuse and 30% of limited scleroderma cases.
- This case underscores that pericardial effusion can, uncommonly, be the presenting sign of scleroderma.
Implications:
- This case broadens the understanding of the clinical spectrum of pericardial disease in scleroderma.
- It suggests that clinicians should consider scleroderma in the differential diagnosis of unexplained large pericardial effusions, even in the absence of other typical signs.
- Further research may elucidate the mechanisms behind atypical presentations of scleroderma-related pericardial involvement.