Barradas Maria Inês, Coutinho Dos Santos Inês, Duarte Fabiana, Tavares Anabela, Martins Dinis
Department of Cardiology, Hospital do Divino Espírito Santo de Ponta Delgada, Avenida D. Manuel I, 9500-370 Ponta Delgada, São Miguel, Portugal.
Eur Heart J Case Rep. 2024 Mar 15;8(4):ytae137. doi: 10.1093/ehjcr/ytae137. eCollection 2024 Apr.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation and is a common cause of pericarditis and pericardial effusion, but significant pericardial effusion and cardiac tamponade are rare and even rarer as the first manifestation.
We report the case of a young male who presented with fever, recurrent pericarditis, and polyserositis with pericardial and bilateral pleural effusion. On examination, he was haemodynamically unstable and the pericardial effusion had considerable dimensions and an urgent pericardiocentesis was performed. Antinuclear antibody with a speckled pattern was positive, complement C4 levels were low, and the remaining autoimmunity and infectious study was unremarkable. Considering the European League Against Rheumatism/American College of Rheumatology classification criteria for SLE, a score of 11 points was obtained, confirming the diagnosis of SLE.
This case report illustrates a rare form of presentation of SLE, in which the first manifestation was pericarditis with polyserositis and cardiac tamponade.
系统性红斑狼疮（SLE）是一种以多系统炎症为特征的慢性自身免疫性疾病，是心包炎和心包积液的常见病因，但大量心包积液和心脏压塞较为罕见，作为首发表现则更为罕见。
我们报告了一名年轻男性病例，该患者表现为发热、复发性心包炎以及伴有心包和双侧胸腔积液的多浆膜炎。检查发现，他血流动力学不稳定，心包积液量较大，遂紧急进行了心包穿刺术。抗核抗体斑点型阳性，补体C4水平降低，其余自身免疫和感染相关检查无异常。根据欧洲抗风湿病联盟/美国风湿病学会SLE分类标准，得分为11分，确诊为SLE。
本病例报告展示了SLE一种罕见的表现形式，其首发表现为伴有多浆膜炎和心脏压塞的心包炎。
