Al Rawahi Anood, Awlad Thani Saif, Alriyami Mohammed, Al Furqani Abdullah, Al-Abrawi Safiya
Pediatrics, Oman Medical Specialty Board, Muscat, OMN.
Pediatric Critical Care, The Royal Hospital, Muscat, OMN.
Cureus. 2025 Mar 4;17(3):e80042. doi: 10.7759/cureus.80042. eCollection 2025 Mar.
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.
儿童期起病的系统性红斑狼疮（cSLE）是一种多系统炎症性自身免疫性疾病，可累及包括心脏在内的多个器官。心包积液作为婴儿早期SLE的主要表现非常罕见。仅在成人和青少年病例报告中，心包积液被报道为SLE的首发症状，报道的最年幼病例为3岁。我们报告一例22个月大的婴儿，该婴儿此前身体健康，但出现心包积液，射血分数降至20%。她进展为心源性休克和急性肾衰竭，需要有创通气、血管活性药物支持和临时透析。她被诊断为SLE，基因检测确诊为常染色体隐性SLE。在开始采用免疫抑制疗法进行SLE治疗后，她的病情显著改善。心包积液仅通过药物治疗就已消退，心脏功能障碍也已恢复。根据现有文献，这是报道的最年幼的以心包积液为表现的SLE病例。该病例强调了在对患有心包炎、心肌炎或心包积液的婴儿进行鉴别诊断时纳入SLE的重要性，以指导早期干预并降低与该疾病相关的风险。
