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Cardiac tamponade in systemic lupus erythematosus
R P Goswami1, G Sircar1, A Ghosh1
1From the Department of Rheumatology, Institute of Post Graduate Medical Education and Research, Kolkata 700107, West Bengal, India.
QJM : Monthly Journal of the Association of Physicians
|October 20, 2017
Summary
Cardiac tamponade is a serious complication in systemic lupus erythematosus (SLE). Pleuritis, anti-nucleosome antibodies, and large pericardial effusions predict tamponade, often managed with immunosuppression.
Area of Science:
- Rheumatology
- Cardiology
- Internal Medicine
Background:
- Cardiac tamponade is a rare but life-threatening complication of systemic lupus erythematosus (SLE).
- Understanding its incidence and risk factors in diverse populations is crucial for timely diagnosis and management.
Purpose of the Study:
- To determine the incidence, identify risk factors, and describe treatment strategies for cardiac tamponade in a large cohort of Indian patients with SLE.
Main Methods:
- A retrospective study was conducted on admitted SLE patients between May 2014 and December 2016.
- Lupus-related serositis was diagnosed after excluding other potential causes.
- Data analysis focused on identifying predictors of cardiac tamponade.
Main Results:
- Of 409 SLE patients, 5.9% developed cardiac tamponade, often as the presenting feature (50%).
- Large pericardial effusions (>20 mm) strongly predicted tamponade (OR: 93.2).
- Pleuritis, anti-nucleosome antibodies, and effusion size were associated with tamponade in smaller effusions.
Conclusions:
- Pleuritis, anti-nucleosome antibodies, and pericardial effusion size are key predictors of tamponade development in SLE patients.
- High-dose immunosuppression, including methylprednisolone and intravenous cyclophosphamide, effectively managed tamponade, reducing the need for surgery in most cases.
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