Key result
NSAIDs, steroids, and hydroxychloroquine resolve acute myopericarditis and effusions in a young male with SLE.
Why the study?
Although cardiac manifestations occur in up to 50% of SLE patients, acute myopericarditis is an uncommon presentation occurring in up to 1% of patients.
Case Report (n=1)
Highlights a rare presentation of SLE as acute myopericarditis, emphasizing the need for early diagnosis and exclusion of tuberculosis before steroid initiation in endemic regions.
Acute myopericarditis warrants SLE consideration in differentials; case report leaves open prevalence and screening needs.
Acute myopericarditis is a rare presentation in clinical practice with multiple aetiologies. Eventhough cardiac manifestations are known to be present in up to 50% of Systemic Lupus Erythematosus (SLE) patients, acute myopericarditis is an uncommon presentation, occurring in up to 1% of patients. Here we report a patient who presented with fever and pleuritic type chest pain and was managed as acute myopericarditis with bilateral exudative pleural effusions and later diagnosed to have SLE. The patients were initially treated with nonsteroidal anti-inflammatory drugs and later with steroids and hydroxychloroquine. Early diagnosis of myopericarditis and identification of the aetiology is essential to halt the progression of disease. Pericarditis due to Tuberculosis need to be excluded before starting steroids in the Sri Lankan setting.
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Wettasinghe et al. (2023) conducted a case report in Systemic Lupus Erythematosus presenting as acute myopericarditis with bilateral pleural effusions (n=1). Ibuprofen, followed by prednisolone and hydroxychloroquine was evaluated on Resolution of symptoms and pericardial effusion. A 22-year-old male presenting with acute myopericarditis and bilateral pleural effusions was successfully diagnosed with Systemic Lupus Erythematosus and treated with NSAIDs, steroids, and hydroxychloroquine, leading to resolution of symptoms and pericardial effusion.
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