Why the study?
Pericardial effusion is common in systemic lupus erythematosus, but subsequent cardiac tamponade is a rare and potentially fatal complication that can exceptionally be the initial presentation.
Cardiac tamponade can be a rare, potentially fatal, and atypical initial presentation of systemic lupus erythematosus, even in young males.
May warrant SLE evaluation in young males with unexplained tamponade and GI symptoms; leaves open incidence beyond this case.
Systemic lupus erythematosus (SLE) is a multisystem, autoimmune condition of extremely variable presentation and prognosis. While pericardial effusion is a common disease sequela, subsequent tamponade is a rare, potentially fatal complication. We present the case of an 18-year-old, previously healthy male who presented to the emergency department with a chief complaint of abdominal pain and hematochezia. Workup revealed massive pericardial effusion with tamponade pathophysiology requiring emergent pericardiocentesis, with further workup confirming a diagnosis of SLE. While SLE often presents in an indolent manner, cardiac tamponade may be the initial presentation of this disease.
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Larson et al. (2019) studied this question.
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