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Systemic lupus erythematosus presenting as effuso-constrictive pericarditis

S R McMechan1, B M McClements, P P McKeown

  • 1Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, Northern Ireland.

Postgraduate Medical Journal
|October 1, 1995
PubMed
Summary
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Systemic lupus erythematosus can manifest as severe pericarditis requiring surgical intervention. Prompt treatment led to a patient's successful recovery and sustained well-being.

Area of Science:

  • Cardiology
  • Rheumatology
  • Internal Medicine

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
  • Pericarditis, inflammation of the sac surrounding the heart, can be a serious complication of SLE.
  • Effuso-constrictive pericarditis presents a diagnostic and therapeutic challenge, potentially leading to hemodynamic compromise.

Observation:

  • A 62-year-old woman with SLE presented with life-threatening effuso-constrictive pericarditis.
  • The patient required surgical drainage of the pericardial effusion.
  • This intervention was crucial for managing the acute cardiac compromise.

Findings:

  • Surgical pericardial drainage effectively treated the effuso-constrictive pericarditis in this SLE patient.

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  • The patient experienced a satisfactory recovery following the procedure.
  • At six-month follow-up, the patient remained clinically stable on hydroxychloroquine and non-steroidal anti-inflammatory drugs.

    • Implications:

    • This case highlights the critical importance of recognizing and managing cardiac involvement in SLE.
    • Aggressive management, including surgical intervention, can lead to favorable outcomes in severe pericarditis associated with SLE.
    • Long-term medical therapy, including hydroxychloroquine, appears effective in maintaining remission post-intervention.