Buppajamrntham Tanas, Palavutitotai Nattawan, Katchamart Wanruchada
J Med Assoc Thai. 2014 Dec;97(12):1234-40.
To investigate the clinical manifestations, diagnosis, etiology, management, and outcomes of patients with systemic lupus erythematosus (SLE) and pericarditis
The authors retrospectively reviewed the records of 81 patients who were diagnosed of SLE according to the American College of Rheumatology criteria and had 82 episodes of pericarditis between 2002 and 2010. The diagnosis of pericarditis was defined as the presence of pericardial effusion alone by echocardiography or having 2 out of 4 of the following criteria: retrosternal pain, pericardial friction rub, widespread ST-segment elevation, and new/worsening pericardial effusion.
Most of them (92%) were female with the median disease duration (range) of 1 (0-312) month. Cardiac tamponade occurred in 16% (95% CI 8.72-25.58%). There was no statistically significant difference between patients who developed tamponade and those who did not. The causes ofpericarditis included active SLE (93%), and suspected tuberculosis (TB) (5%), with 2% inconclusive. In patients with lupus pericarditis, 71% had other active organ involvement. Most lupus pericarditis patients (79%) had good response to steroid or NSAIDs. Diagnosis of TB pericarditis was made by clinical suspicion without microbiological or pathological evidence.
In an endemic area of TB, lupus pericarditis was still the most common cause of pericarditis in SLE. Most patients responded well to steroid.
探讨系统性红斑狼疮（SLE）合并心包炎患者的临床表现、诊断、病因、治疗及预后。
作者回顾性分析了2002年至2010年间81例根据美国风湿病学会标准诊断为SLE且发生82次心包炎发作的患者记录。心包炎的诊断定义为超声心动图单独显示心包积液，或具备以下4项标准中的2项：胸骨后疼痛、心包摩擦音、广泛ST段抬高以及新出现/加重的心包积液。
大多数患者（92%）为女性，疾病持续时间中位数（范围）为1（0 - 312）个月。16%（95%可信区间8.72 - 25.58%）发生心脏压塞。发生心脏压塞的患者与未发生者之间无统计学显著差异。心包炎的病因包括活动性SLE（93%）、疑似结核病（TB）（5%），2%病因不明。狼疮性心包炎患者中，71%有其他活动性器官受累。大多数狼疮性心包炎患者（79%）对类固醇或非甾体抗炎药反应良好。结核性心包炎的诊断基于临床怀疑，无微生物学或病理学证据。
在结核病流行地区，狼疮性心包炎仍是SLE患者心包炎的最常见病因。大多数患者对类固醇反应良好。
