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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
Insights
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.
- 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.
Abstract:
We describe a 62-year-old woman in whom systemic lupus erythematosus presented as life-threatening effuso-constrictive pericarditis. Surgical drainage of the pericardium was required and the patient made a satisfactory recovery. At six-months follow-up, while taking hydroxychloroquine and a non-steroidal anti-inflammatory agent, she remains well.
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