产后早期系统性红斑狼疮合并心脏压塞及心肌水肿
Systemic Lupus Erythematosus With Cardiac Tamponade and Myocardial Edema in the Early Postpartum Period.
作者信息
Shabbir Asad, Abdulsalam Fatima A M, Dawkins Sam, Spartera Marco, Boardman Henry, Cairns Alexandra E, Psarras Antonios, Orchard Elizabeth, Wijesurendra Rohan
机构信息
John Radcliffe Hospital, Oxford University Hospital Trust, Oxford, United Kingdom.
John Radcliffe Hospital, Oxford University Hospital Trust, Oxford, United Kingdom; Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, United Kingdom; Rheumatology Department, Nuffield Orthopaedic Centre, Oxford University Hospital Trust, Oxford, United Kingdom.
出版信息
JACC Case Rep. 2025 Jul 30;30(21):104399. doi: 10.1016/j.jaccas.2025.104399.
BACKGROUND
Pericardial effusions are frequently caused by inflammatory diseases. In cases of serosal inflammation, which often present with concomitant systemic symptoms, cardiac tamponade can occur, requiring emergency drainage. Nevertheless, it is rare for the index presentation of a previously undiagnosed inflammatory disease to be with cardiac tamponade.
CASE SUMMARY
We describe a case of a young woman who presented in the postpartum period with cardiac tamponade. Further investigations confirmed that the underlying diagnosis was systemic lupus erythematosus (SLE).
DISCUSSION
SLE can be associated with pericardial effusion but rarely causes cardiac tamponade. Herein, we describe a case of an index presentation of SLE in the postpartum period with a large pericardial effusion and tamponade. Cardiac imaging showed myocardial edema, reflective of associated myocarditis.
TAKE-HOME MESSAGES: SLE can present in the immediate postpartum period, and acute management of tamponade in this context includes drainage of the effusion and immunosuppressive therapy.
背景
心包积液常由炎症性疾病引起。在浆膜炎症的病例中，常伴有全身症状，可发生心脏压塞，需要紧急引流。然而，既往未诊断的炎症性疾病以心脏压塞为首发表现的情况较为罕见。
病例摘要
我们描述了一例年轻女性在产后出现心脏压塞的病例。进一步检查证实潜在诊断为系统性红斑狼疮（SLE）。
讨论
SLE可伴有心包积液，但很少导致心脏压塞。在此，我们描述了一例产后SLE以大量心包积液和压塞为首发表现的病例。心脏成像显示心肌水肿，提示合并心肌炎。
要点
SLE可在产后即刻出现，在此情况下心脏压塞的急性处理包括积液引流和免疫抑制治疗。
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