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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
PubMed

Insights

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.
Abstract

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