Cardiac tamponade in systemic lupus erythematosus. Report of four cases

Castier, Márcia Bueno; Albuquerque, Elisa; Menezes, Michel; Klumb, Evandro Mendes; Filho, Francisco Manes Albanesi

doi:10.1590/s0066-782x2000001100008

Cited by 32 publications

(19 citation statements)

References 33 publications

(37 reference statements)

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“…Pericarditis is clinically evident in 20-30% of the patients along the course of their disease. Cardiac tamponade is rare, with an incidence ranging from 1.23% to 2.5% in two large retrospective series 3 , 4. Clinical manifestations of myocarditis are also rare; however, the signs of inflammation have been seen in 40-80% at autopsy 5.…”

Section: Discussionmentioning

confidence: 99%

Sudden death in infective endocarditis

Castelli¹,

Almeida²,

Siciliano³

2016

ACR

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The case fatality rate of infective endocarditis (IE) is high and is associated with varying causes. Among them, acute myocardial infarction due to an embolism in a coronary artery is rare; the incidence of this complication in the setting of IE is reported to be up to 1.5%. We report a case of sudden death in a 22-year-old woman diagnosed with systemic lupus erythematosus who was referred to the Cardiology Center for the treatment of mitral valve incompetence due to IE. She was hemodynamically stable with antibiotic therapy and vasoactive drugs, despite severe mitral valve regurgitation. Unexpectedly, she presented cardiac arrest and died. The autopsy showed total occlusion of the left main coronary artery by septic embolus, which originated from the mitral vegetation, as the cause of death. Thus, although a rare complication, it should always be kept in mind that a coronary embolism can be a lethal complication of IE, and the possibility of surgical treatment combined with the underlying antibiotic therapy should be raised.

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Section: Discussionmentioning

confidence: 99%

Sudden death in infective endocarditis

Castelli¹,

Almeida²,

Siciliano³

2016

ACR

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“…Pericardial effusion in hypothyroid patients has been attributed to increased capillary permeability and impaired lymphatic drainage (6). Although the basis of an association of Graves' disease with bloody pericardial effusion is unknown, some patients with systemic lupus erythematosus have been reported to develop such effusion (8,11); autoimmune mechanisms therefore may be involved. Analysis of more cases is needed to fully establish bloody pericardial effusion as a complication of Graves' disease, and to better understand the pathophysiologic basis for this association.…”

Section: Discussionmentioning

confidence: 99%

A Patient with Graves' Disease Accompanied by Bloody Pericardial Effusion

et al. 2005

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A hyperthyroid patient with bloody pericardial effusion is presented. He was hospitalized for severe dyspnea. Pericardiocentesis yielded 1.2 liters of bloody fluid. Biochemical, cytologic, and radiologic examinations failed to identify the etiology of the effusion. Upon normalization of thyroid function using antithyroid drugs, the pericardial effusion resolved without recurrence. The patient was diagnosed as Graves' disease, which rarely is complicated by bloody pericardial effusion. As it is rarely reported and not widely known, this association may be underdiagnosed. (Internal Medicine 44: 1064-1068, 2005)

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“…In those patients with known SLE, prior cases of cardiac tamponade have reportedly responded well to high-dose corticosteroids (11). Given that tamponade can occur at any point in the course of SLE, this lifethreatening diagnosis should be considered in patients with unexplained venous congestion.…”

Section: Diagnosismentioning

confidence: 99%