Pericardial tamponade: A major presenting manifestation of hydralazine-induced lupus syndrome

Abstract

Hydralazine, a frequently prescribed antihypertensive, may produce a syndrome clinically similar to systemic lupus erythematosus. Cardiac manifestations, however, are generally uncommon in hydralazine-induced lupus. We describe the unusual development of pericarditis and pericardial tamponade in a patient treated with hydralazine who demonstrated clinical and laboratory evidence for the drug-induced syndrome. Treatment with prednisolone produced dramatic amelioration of the pericarditis. No recurrent manifestations of the lupus syndrome occurred after cessation of steroid therapy. If signs and symptoms of cardiac disease develop in hypertensive patients receiving hydralazine, the possibility of drug-induced lupus pericarditis should be considered.