Effusive–Constrictive Pericarditis with Pleural Effusion: A Rare Initial Presentation in Systemic Lupus Erythematosus

Although tuberculosis (TB) remains a prevalent cause of constrictive pericarditis that presents with pleural effusion in high-endemic countries like India, other causes of serositis should also be considered.Serositis-like pericarditis, pleuritis, and peritonitis-is the most predominant clinical manifestation of systemic lupus erythematosus (SLE), an autoimmune disorder.Serositis accounts for an incidence of 11-54% in SLE.Pericardial effusion and cardiac tamponade are the rare initial manifestations of SLE.Effusive-constrictive pericarditis (ECP) and bilateral pleural effusion with no articular and cutaneous involvement are rare.Effusive-constrictive pericarditis is a rare syndrome that causes constriction of the visceral pericardium and effusion that produces a tamponade-like effect on the heart.Medical management includes treating the underlying cause of inflammation with steroids and non-steroid anti-inflammatory drugs, followed by diuretics to relieve the volume overload symptoms.The only effective treatment for ECP is pericardiectomy, which involves removing both the parietal and visceral pericardium.