Key result
Immunosuppression therapy resolves pericardial effusion and cardiac dysfunction in an infant with SLE.
Why the study?
Pericardial effusion as a primary manifestation of systemic lupus erythematosus in early infancy is very rare and previously reported only in older children and adults.
Case Report (n=1)
This case highlights the importance of including systemic lupus erythematosus in the differential diagnosis for infants presenting with pericardial effusion or cardiac dysfunction to guide early intervention.
Supports considering immunosuppression alone in rare infant cases; leaves open confirmation in larger SLE cohorts.
Childhood-onset systemic lupus erythematosus (cSLE) is a multi-systemic, inflammatory autoimmune disease that affects many organs including the heart. Pericardial effusion as a primary manifestation of SLE in early infancy is very rare. It has been reported as the first symptom of SLE in adult and adolescent case reports only and the youngest reported case was a three-year-old. We report a case of a 22-month-old infant who had previously been healthy but presented with pericardial effusion and a reduced ejection fraction of 20%. She progressed to cardiogenic shock and acute renal failure and required invasive ventilation, inotropic support and temporary dialysis. She was diagnosed with SLE that was genetically confirmed as autosomal recessive SLE. Her condition improved significantly after starting SLE management with immunosuppression therapy. Pericardial effusion has resolved with medical therapy only and cardiac dysfunction has recovered. According to the available literature, this is the youngest reported case of SLE manifesting as pericardial effusion. This case highlights the importance of including SLE in the differential diagnosis for infants presenting with pericarditis, myocarditis, or pericardial effusion to guide early intervention and reduce risks associated with the disease.
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Thani et al. (2025) conducted a case report in Systemic Lupus Erythematosus (n=1). Immunosuppression therapy was evaluated on Clinical improvement, resolution of pericardial effusion, and recovery of cardiac dysfunction. Immunosuppression therapy successfully resolved pericardial effusion and recovered cardiac dysfunction in a 22-month-old infant presenting with systemic lupus erythematosus.
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