Pericarditis in systemic lupus eythematosis

Abstract

Pericarditis is a common cardiac manifestation in Systemic Lupus Erythematosus (SLE). However, little is known about clinical or immunological associations of pericarditis. The aim of this study is to analyze predictors’ factors of lupus pericarditis as well as the treatment response and long-term outcomes. We retrospectively reviewed the records of 238 patients with SLE, as defined by the ACR who were admitted in Fattouma Bourguiba University Hospital between 2010 and 2020. The diagnosis of pericarditis was defined as the presence of pericardial effusion by echocardiography. Forty-tow patients (17.6%, 7 men and 35 women) had pericerditis. Median age was 37 years (range 13–64). pericarditis was the first sign of SLE in 11/42 cases (26,1%). The mean duration of SLE at the time of pericarditis was 17 months. typical sharp precordial pain and dyspnea occurred in 10/42 (23.8%) cases. in patients with lupus pericarditis 50% had pleuritis. Clinical factors significantly associated with pericarditis were lupus nephritis ( P = 0.000), pulmonary hypertension ( P = 0.041), fever (0.026) and haemolytic anemia (0.046). Serological profile in patients with lupus pericarditis included; 92.7% AAN, 69% anti-DNA 69% antibodies, 29.3% anti SM antibodies, 36,6% anti SSA antibodies and 22% anti RNP antibodies. It was highly associated with antiphospholipide antibodies ( P = 0.029). Fifteen patients were treated with at least 0.5 mg/kg/day of prednisone. In tow patients with tomponad, a higher dose of corticosteroid was necessary. Pericarditis is one of the most characteristic disease manifestations. It may remain clinically silent and evidence of previous pericardial disease is often observed on echocardiography. Cardiac tamponade is a critical diagnosis to consider, though is an uncommon presentation in SLE.