Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease that can involve any organ system, exhibiting great diversity in presentation. Cardiac tamponade as the initial presentation of childhood onset SLE (cSLE) is rare. We report the case of a 10 year old Afro-Caribbean female who presented with complaints of chest pain, shortness of breath and fever over 4 days. Clinical examination strongly suggested cardiac tamponade which was confirmed by investigations and treated with pericardiocentesis. After a thorough investigation, the underlying diagnosis of SLE was confirmed using the Systemic Lupus International Collaborating Clinics (SLICC) criteria and high dose corticosteroid therapy initiated. A review of recent studies shows that common initial presentations of cSLE include constitutional symptoms, renal disease, musculoskeletal and cutaneous involvement. In presenting this case and reviewing the literature we emphasize the importance of cSLE as a differential diagnosis when presented with pericarditis in the presence or absence of cardiac tamponade. In these patients early diagnosis and treatment is desired and in this regard we also discuss the sensitivity of the SLICC criteria in cSLE.Electronic supplementary materialThe online version of this article (doi:10.1186/s12969-015-0005-0) contains supplementary material, which is available to authorized users.
Highlights
Systemic lupus erythematosus (SLE) is an autoimmune disease that can involve any organ system resulting in a great diversity of clinical presentation
Pericarditis and pericardial effusions in SLE are well recognized in SLE
Cardiac tamponade is a medical emergency that develops when a pericardial effusion reaches a critical amount, limiting cardiac inflow and leading to hemodynamic compromise. In this case report we present and discuss pericarditis leading to cardiac tamponade as the initial manifestation of childhood onset systemic lupus erythematosus (cSLE)
Summary
Systemic lupus erythematosus (SLE) is an autoimmune disease that can involve any organ system resulting in a great diversity of clinical presentation. Cardiac tamponade is a medical emergency that develops when a pericardial effusion reaches a critical amount, limiting cardiac inflow and leading to hemodynamic compromise In this case report we present and discuss pericarditis leading to cardiac tamponade as the initial manifestation of cSLE. The left-sided chest pain was described as “squeezing,” and was associated with palpitations Both the pain and shortness of breath were worse in the supine position and partially relieved on leaning forward. There was no known family history of autoimmune disease On examination she had a heart rate of 135 bpm, a respiratory rate of 40 breaths/min, blood pressure of 93/63 mmHg and a temperature of 37.7°C. HIV testing and a Figure 2 Posteroanterior chest radiograph at presentation revealed a markedly enlarged cardiac silhouette and a left-sided pulmonary infiltrate. At the follow up visit she continued to do well and was enrolled in clinic for long term management of cSLE
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
