Constrictive Pericarditis as an Initial Manifestation of Systemic Lupus Erythematosus

A young female presented with new-onset rash, oral ulcers and dyspnea without overt features of heart failure. She was diagnosed with systemic lupus erythematosus with early constrictive pericarditis, cutaneous lupus and serositis in the form of pericardial and pleural effusion. There was no renal, neurological and joint involvement. She was treated with steroid pulse and other ancillary drugs that led to remission with improvement in the symptoms and reversal of echocardiographic changes of constrictive pericarditis. Oral steroids were successfully tapered off after four months, and only hydroxychloroquine was continued. Constrictive pericarditis is an uncommon feature of lupus and its occurrence as an initial manifestation, without a history of repeated episodes of acute pericarditis, is rarely reported.