Why the study?
Cardiac tamponade is a rare presentation of SLE, occurring in less than 1% of cases, and its coexistence with Addison's disease represents an even rarer clinical scenario.
Cardiac tamponade can be a rare initial presentation of coexistent systemic lupus erythematosus and Addison's disease, requiring prompt recognition, pericardiocentesis, and targeted medical therapy.
May prompt dual rheumatologic-endocrine workup in tamponade with hyponatremia; leaves open whether this overlap warrants routine screening.
Cardiac tamponade is a rare presentation of systemic lupus erythematosus (SLE), occurring in less than 1% of cases. Its coexistence with primary adrenal insufficiency (Addison’s disease) represents an even rarer clinical scenario. We present the case of a 28-year-old female who presented with cardiac tamponade as the initial presentation of concurrent SLE and Addison’s disease. Laboratory investigations revealed positive antinuclear and anti-dsDNA antibodies, low complement levels, hyponatremia, and hyperkalemia. Adrenal function tests confirmed primary adrenal insufficiency. Echocardiography identified a large pericardial effusion with cardiac tamponade, necessitating emergent pericardiocentesis. The patient responded well to high-dose glucocorticoids, hydroxychloroquine, and mineralocorticoid replacement therapy. This case highlights the rare and challenging presentation of cardiac tamponade as the initial presentation of the coexistent SLE and Addison’s disease. Prompt recognition and management of this complex scenario are crucial. Clinicians should maintain a high index of suspicion for underlying autoimmune disorders in patients presenting with cardiac tamponade.
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Keshek et al. (2025) studied this question.
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