Pericarditis In Systemic Lupus Erythematosus Research Articles

A RARE CAUSE OF A NON-REMITTING PERICARDIAL EFFUSION IN A PATIENT WITH LUPUS

Systemic lupus erythematosus (SLE) is associated with a variety of cardiac and systemic complications such as pericarditis. However, chylous pericarditis in SLE has not previously been reported. We present the case of a 26 year old female with a history of SLE, and known pericardial effusion found

Pericarditis in Lupus.

Pericarditis is a common cardiac manifestation in systemic lupus erythematosus (SLE). Serositis is recognized in the ACR, SLICC, and EULAR/ACR classification criteria. We reviewed the prior research regarding the epidemiology, risk factors, presentation, and treatment of pericarditis in SLE.

FEATURES OF HEART LESION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (LITERATURE REVIEW)

An analysis of national and foreign scientific literature about the features of heart damage in systemic lupus erythematosus (SLE) is carried out. This topic is very relevant, because according to different authors, the frequency of cardiovascular system (CVS) damage in SLE ranges from 52 to 89%. Mortality because of SLE is three times higher than in the population, while among its causes, CVS ranks third after infections and renal failure.
 The results of numerous studies about the features of the clinical picture, diagnosis and treatment of SLE patients with primary lesions of the heart are presented and analyzed. Particular attention is paid to lupus myocarditis (LM), endocarditis Libman–Sacks, as well as rhythm and conduction disturbances.
 LM often makes its debut at early stage of SLE and in most cases is not clinically manifested. That is why LM is difficult to diagnose. LM can lead to arrhythmias, conduction disturbances, dilated cardiomyopathy (DCM), heart failure (HF) and even sudden death. The myocardium is involved in the pathological process according to autopsy in 40–80% of cases, but cardiovascular disorders are absent only in 7,5% of patients. Echocardiography (EchoCG), speckle-tracking EchoCG, MRI of the heart are necessary methods for the diagnosis of active or transferred LM. Early aggressive immunosuppressive therapy significantly improves the prognosis.
 The detection rate of pericarditis in SLE is 25,6%. It was found in 62,1% of cases according to autopsy results. Pericarditis is usually combined with endocarditis or endomocarditis.
 The morphological basis of heart defects that are formed in SLE is non–bacterial endocarditis of Libman–Sacks. The frequency of endocarditis is 73,3%. The course of endocarditis is predominantly benign and does not cause significant hemodynamic disturbances.
 The frequency of rhythm disturbance remains quite high in all age groups of patients with SLE. It’s diagnosis is difficult due to the asymptomatic course and frequent joining of concomitant cardiovascular pathology.

Associates and predictors of pleurisy or pericarditis in SLE

Background/PurposeSerositis is one of both ACR and SLICC classification criteria for systemic lupus erythematosus (SLE) and a common type of extra renal flare. However, little is known about clinical or...

The prevalence and risk factors for serositis in patients with systemic lupus erythematosus: a cross-sectional study.

This study aims to estimate the prevalence of serositis and identify risk factors for serositis in a large cohort of systemic lupus erythematosus (SLE) patients. A cross-sectional study was conducted based on the medical records of patients hospitalized with SLE at the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital. Patients were diagnosed with serositis when they presented with symptoms and signs of pleuritis or/and pericarditis. We explored factors associated with the generation and quantity of serositis by using binary and ordinal logistic regression analysis. Among the 1668 lupus patients, 298 have serositis. Active lupus disease, fever (≥38°C) and high D-dimer were all significantly associated with the generation and quantity of serositis. Male gender was independent significant risk factor for pleuritis but not for pericarditis, while low complement C4 and high erythrocyte sedimentation rate (ESR) were risk factors for pericarditis rather than for pleuritis. The possible prevalence of serositis in patients with SLE was 17.9%. The significant associations of active lupus disease, fever (≥38°C) and high D-dimer with serositis suggest that higher disease activity and hypercoagulability may both contribute to the generation and development of serositis in SLE. The risk factors for pleuritis and pericarditis in SLE are similar but not identical.

Colchicine: a simple and effective treatment for pericarditis in systemic lupus erythematosus? A report of 10 cases

Pericardial involvement is a frequent manifestation of systemic lupus erythematosus (SLE). Growing evidence suggests that colchicine may be useful for acute or recurrent pericarditis. We report for the first time a series of 10 consecutive cases of SLE with pericarditis treated with colchicine. Inclusion criteria in this retrospective study were diagnosis of SLE, pericarditis and receiving colchicine. We included 10 consecutive cases of SLE with pericarditis treated with colchicine (nine women, mean age at the index pericarditis 35 ± 12 years). Pericarditis was the initial manifestation of SLE for two patients, whereas eight patients had SLE lasting for a median of 2.5 years (15 days to 13 years) and had received prednisone (n = 7, 2-30 mg/d), hydroxychloroquine (n = 7), azathioprine (n = 3), methotrexate (n = 2), and mycophenolate mofetil (n = 1). For six patients, pericarditis was associated with other SLE manifestations. Altogether, colchicine avoided the use (n = 2) or increase in dosage (n = 5) of steroids in seven cases; the increase in steroids dosage was minimal for two patients. Colchicine 1 mg was given for a median of 39 days (10 days to 54 months). Symptoms completely resolved after a median of 2.5 days (1-30 days) after initiation of colchicine. Colchicine was maintained or resumed in six patients to prevent recurrence, with no further relapse. Colchicine may be safe and effective in treating SLE pericarditis and used as a steroids-sparing agent. These preliminary results need to be confirmed in a larger study with longer follow-up.

Cardiac involvement in systemic inflammatory diseases

Systemic inflammatory diseases represent a large group of rare diseases that may involve all organs and also the heart. The three layers of the heart can be affected and some manifestations such as pericarditis in systemic lupus erythematosus are rather well known, yet others are not known even for cardiologists. Modern sophisticated imaging techniques reveal cardiac abnormalities in most of these diseases and the reported frequency of cardiac involvement ranges widely depending upon the applied diagnostic methods and selection of patients. The clinical significance of these findings is not always established. However, better knowledge and awareness of cardiac involvement is necessary because it conveys a major risk for mortality in several of these rare diseases.

Cardiac tamponade by staphylococcus aureus infection in a case of systemic lupus erythematosus

We have experienced a case of systemic lupus erythematosus (SLE) with cardiac tamponade caused by staphylococcus aureus infection. The patient had been treated as SLE for three years at our patient clinic. After the administration of antibiotics for her cervical lymphoadenopathy following dental therapy, ulnar and palmar erythema were aggravated.Steroid pulse therapy was performed for her exacerbation. Three days after the pulse therapy, low blood pressure, tachycardia, paradoxical pulse and friction rub sound were appeared and echocardiogram demonstrated a large quantity of pericardial effusion, from which staphylococcus aureus was detected.After the drainage and administration of effective antibiotics for that bacteria, her symptomes were remarkably improved. Pericarditis in SLE is the most common cardiac manifestation. But infectious pericarditis and cardiac tamponade is rare. In this case we suspect the focus of this infection was digital ulcer or cervical lymphonode.

Immune Complexes in the Pericardial Fluid in Systemic Lupus Erythematosus

Two patients with systemic lupus erythematosus (SLE) had pericardial tamponade. The pericardial fluid from both patients contained "mixed" type cryoglobulins consisting of IgG, IgM, and C1q. There was a selective concentration of antinuclear antibodies in the pericardial fluid cryoglobulin of one patient. Pericardial fluid from the same patient contained immune complexes. Anti-DNA antibodies were found in the serum, pericardial fluid, and pericardial fluid cryoprotein. Immune complexes isolated from the pericardial fluid by polyethylene complexes isolated from the pericardial fluid by polyethylene glycol precipitation contained antinuclear antibodies including anti-DNA antibodies. Immune complexes may be important in the pathogenesis of pericarditis in SLE.

Pericardial effusion and mitral valve involvement in systemic lupus erythematosus. Echocardiographic study.

Echocardiography was used in 30 women and 2 men with systemic lupus erythematosus (SLE) in order to determine the incidence and severity of pericardial effusion and mitral valve involvement. 31 patients showed normal thickness of the mitral valve leaflets, only one patient showed irregular thickening of the leaflets suggesting the presence of vegetations. Mitral valve motions were normal in all patients. These results indicate that myocardial and valvular involvement in SLE is usually not severe enough to result in haemodynamic abnormalities. Pericardial effusion was found in 2 patients who were symptom free, whereas 4 of the patients with a past history suggestive of pericarditis showed no echocardiographic evidence of pericardial effusion. These suggest the transient nature of pericarditis in SLE, and the value of echocardiography as a diagnostic tool in detecting clinically inapparent lupus pericarditis.