Large pericardial effusions due to systemic lupus erythematosus: A report of eight cases
Date
2005
Authors
Weich H.S.V.H.
Burgess L.J.
Reuter H.
Brice E.A.
Doubell A.F.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
The aim of this study was to describe the clinical, echocardiographic and laboratory characteristics of large pericardial effusions and cardiac tamponade secondary to systemic lupus erythematosus (SLE). An ongoing prospective study was conducted at Tygerberg Academic Hospital, South Africa between 1996 and 2002. All patients older than 13 years presenting with large pericardial effusions (> 10 mm) requiring pericardiocentesis were included. Eight cases (out of 258) were diagnosed with SLE. The mean (SD) age was 29.5 (10.7) years. Common clinical features were Raynaud's phenomenon, arthralgia and lupus nephritis class III/IV. Echocardiography showed Libman-Sacks endocarditis (LSE) in all the mitral valves. Two patients developed transient left ventricular dysfunction; both these patients had pancarditis. Typical serological findings included antinuclear antibodies, anti-double stranded DNA antibodies, low complement C4 levels and low C3 levels. CRP was elevated in six cases. Treatment consisted of oral steroids and complete drainage of the pericardial effusions. No repeat pericardial effusions or constrictive pericarditis developed amongst the survivors (3.1 years follow up). This study concludes that large pericardial effusions due to SLE are rare, and associated with nephritis, LSE and myocardial dysfunction. Treatment with steroids and complete drainage is associated with a good cardiac outcome. © 2005 Edward Arnold (Publishers) Ltd.
Description
Keywords
antinuclear antibody, C reactive protein, complement component C3, complement component C4, cyclophosphamide, DNA antibody, double stranded DNA, methylprednisolone, prednisone, adolescent, adult, antibody blood level, arthralgia, article, clinical article, clinical feature, constrictive pericarditis, controlled study, disease association, endocarditis, female, follow up, heart left ventricle failure, heart tamponade, human, laboratory test, libman sacks endocarditis, lupus erythematosus nephritis, male, pericardial effusion, pericardiocentesis, priority journal, prognosis, Raynaud phenomenon, systemic lupus erythematosus, Adolescent, Adult, Drainage, Echocardiography, Electrocardiography, Fatal Outcome, Female, Humans, Immunosuppressive Agents, Lupus Erythematosus, Systemic, Male, Pericardial Effusion, Prednisone
Citation
Lupus
14
6
14
6