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Cardiac tamponade as an initial presentation for systemic lupus erythematosus.
Li, William; Frohwein, Thomas; Ong, Kenneth.
Affiliation
  • Li W; Internal Medicine, SUNY Upstate Medical University, United States. Electronic address: liwi@upstate.edu.
  • Frohwein T; Internal Medicine, Lincoln Medical and Mental Health Center, United States.
  • Ong K; Cardiology, Lincoln Medical and Mental Health Center, United States.
Am J Emerg Med ; 35(8): 1213.e1-1213.e4, 2017 Aug.
Article in En | MEDLINE | ID: mdl-28526593
Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease which follows a relapsing and remitting course that can manifest in any organ system. While classic manifestations consist of arthralgia, myalgia, frank arthritis, a malar rash and renal failure to name a few, cardiac tamponade, however, is a far less common and far more dangerous presentation. We highlight the case of a 61year-old male with complaints of acute onset shortness of breath and generalized body aches associated with a fever and chills in the ER. A bedside echocardiogram revealed a significant pericardial effusion concerning for pericardial tamponade. An emergent pericardiocentesis performed drained 800mL of serosanguinous fluid. While denying a history of any rash, photosensitivity, oral ulcers, or seizures, his physical examination did reveal metacarpal phalangeal joint swelling along with noted pulsus paradoxus of 15-200mmHg. Subsequent lab work revealed ANA titer of 1:630 and anti-DS DNA antibody level of 256IU/mL consistent with SLE. This case highlights cardiac tamponade as a rare but life-threatening presentation for SLE and raises the need to keep it in the differential when assessing patients presenting with pertinent exam findings.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pericardial Effusion / Echocardiography / Cardiac Tamponade / Pericardiocentesis / Lupus Erythematosus, Systemic Limits: Humans / Male / Middle aged Language: En Journal: Am J Emerg Med Year: 2017 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pericardial Effusion / Echocardiography / Cardiac Tamponade / Pericardiocentesis / Lupus Erythematosus, Systemic Limits: Humans / Male / Middle aged Language: En Journal: Am J Emerg Med Year: 2017 Document type: Article