Key result
Triple immunosuppression linked to resolution of massive pericardial effusion in new-onset SLE.
Why the study?
Massive pericardial effusion as an initial presentation of systemic lupus erythematosus is unusual and not well characterized.
Case Report (n=1)
Massive pericardial effusion can be an unusual initial presentation of systemic lupus erythematosus, highlighting the need to screen for autoimmune diseases in patients with unexplained cardiopulmonary symptoms.
Answers are grounded in this paper and cite their sources.
Massive pericardial effusion may signal initial SLE; hypothesis-generating and should not yet change practice.
Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder with multiple system involvements whichcommonly affects the cardiovascular system. Although pericarditis and pericardial effusion are prevalent cardiac manifestationsin SLE, massive pericardial effusion as an initial presentation is unusual. We describe a 47-year-old woman who presented tothe hospital with a headache, dry cough, shortness of breath, and fatigue. According to the clinical, radiologic, echocardiographicand laboratory rheumatologic test findings, SLE was diagnosed and treatment with prednisolone, hydroxychloroquine, andmycophenolate mofetil was initiated. The patient improved clinically, and follow-up echocardiography showed a reduction inthe effusion volume compared with previous tests within the preceding 6 months. In patients with cardiopulmonary symptoms,especially when other organ involvement is seen, screening for autoimmune systemic diseases such as SLE should beconsidered. To achieve rapid recovery and prevent life-threatening complications, early diagnosis and treatment are essential.
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Kavandi et al. (2020) conducted a case report in Systemic lupus erythematosus with massive pericardial effusion (n=1). Prednisolone, hydroxychloroquine, and mycophenolate mofetil was evaluated on Reduction in pericardial effusion volume and clinical improvement. Treatment with prednisolone, hydroxychloroquine, and mycophenolate mofetil led to clinical improvement and a significant reduction in massive pericardial effusion volume over 6 months in a patient with new-onset SLE.
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