Acute cardiac tamponade can be a rare first manifestation of SLE in children, highlighting the importance of routine ANA and anti-dsDNA screening in pediatric patients with unexplained pericardial effusion to prevent delayed diagnosis and treatment.
May prompt ANA screening in unexplained pediatric tamponade; leaves open need for prospective validation before changing practice.
Systemic lupus erythematosus (SLE) is a serious chronic autoimmune disease with intense inflammatory response and damage in many target organs including joints, skin, kidneys, heart and nervous system. Cardiac tamponade is extremely rare as a cardinal presentation of SLE in children with only a few cases reported in the literature. We report two cases of a 9-year-old boy and an 11-year-old girl presenting with acute cardiac tamponade and later recognition of elevated anti-double-stranded DNA (anti-dsDNA) titre. We also present a literature review about similar cases in children and we stress on the importance of screening all cases of acute cardiac tamponade in children with antinuclear and anti-dsDNA antibodies to avoid any delay in SLE diagnosis and treatment.
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Arabi et al. (2012) studied this question.
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