Cardiac Tamponade in a Patient With Mixed Connective Tissue Disease

Arroyo-Ávila, Mariangelí; Vilá, Luis M.

doi:10.1097/rhu.0000000000000209

Cited by 7 publications

(4 citation statements)

References 6 publications

(13 reference statements)

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“…Mixed connective tissue disease (MCTD) could also be part of the differential diagnosis. MCTD is known to cause effusions and tamponade ( 9 ) and it is an overlap syndrome associated with ENA antibodies that incorporates selected clinical features of SLE, systemic sclerosis (scleroderma) and polymyositis.…”

Section: Discussionmentioning

confidence: 99%

Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2

Vryonidou

Paschou

Dimitropoulou

et al. 2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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We describe a case of a 40-year-old woman who was admitted to the intensive care unit with a rapid onset of dyspnea and orthopnea. She presented progressive weakness, weight loss and secondary amenorrhea during last year, while intermittent fever was present for the last two months. Initial biochemical evaluation showed anemia, hyponatremia and increased C-reactive protein levels. Clinical and echocardiographic evaluation revealed cardiac tamponade, which was treated with pericardiocentesis. Pleural fluid samples were negative for malignancy, tuberculosis or bacterial infection. Hormonal and serologic evaluation led to the diagnosis of autoimmune polyglandular syndrome (APS) type 2 (including primary adrenal insufficiency and autoimmune thyroiditis), possibly coexisting with systemic lupus erythematosus. After symptomatic rheumatologic treatment followed by replacement therapy with hydrocortisone and fludrocortisone, the patient fully recovered. In patients with the combination of polyserositis, cardiac tamponade and persistent hyponatremia, possible coexistence of rheumatologic and autoimmune endocrine disease, mainly adrenal insufficiency, should be considered. Early diagnosis and non-invasive treatment can be life-saving.Learning points:In patients with the combination of polyserositis, cardiac tamponade and persistent hyponatremia, possible coexistence of rheumatologic and autoimmune endocrine disease, mainly adrenal insufficiency, should be considered.Early diagnosis and non-invasive treatment can be life-saving for these patients.Primary adrenal insufficiency requires lifelong replacement therapy with oral administration of 15–25 mg hydrocortisone in split doses and 50–200 µg fludrocortisone once daily.

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Section: Discussionmentioning

confidence: 99%

Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2

Vryonidou

Paschou

Dimitropoulou

et al. 2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…The most common cardiac manifestation of the disease is pericarditis and cardiac tamponade is rarely described in the natural course of the disease. Other cardiac complications include myocardial dysfunction secondary to pulmonary hypertension as well as accelerated atherosclerosis [ 8 - 11 ]. Non-invasive cardiac tests including EKG and echocardiography are essential for early diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Massive Hemorrhagic Pericardial Effusion With Cardiac Tamponade as Initial Manifestation of Mixed Connective Tissue Disease

et al. 2018

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Mixed connective tissue disease (MCTD) is a distinct entity of connective tissue disorders characterized by overlapping clinical features of various autoimmune diseases along with the presence of antibodies to ribonucleoprotein (anti-RNP). The prevalence of cardiac involvement in MCTD varies from 13% to 65% and accounts for approximately 20% of MCTD related mortality. In this case, we describe an elderly female patient with multiple complaints without a clear etiology on presentation. Echocardiogram revealed severe rapidly accumulating pericardial effusion causing tamponade necessitating pericardial window. Laboratory investigations showed positive ribonucleoprotein antibodies. Biopsy of pericardial tissue revealed fibrinous pericarditis. While pericarditis is commonly associated with MCTD, pericardial tamponade on the other hand is rarely described. This case highlights a very rare complication of the disease. Early recognition, prompt treatment, and regular follow-up with serial echo are essential for treatment.

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“…At the same time, adverse environmental factors play an important role in clinical manifestation of this condition [7,8]. The combination of these factors leads to pathological change in elastin and collagen fibers facilitating significant restructuration of connective tissue of different severity [9], which determines the large spectrum of CTD morphological manifestations [10][11][12][13][14][15]. According to existing studies, СTD is quite common, reaching an incidence of up to 85.4% in some populations [16,17].…”

Section: Introductionmentioning

confidence: 99%

Morphological signs of connective tissue dysplasia as predictors of frequent post-exercise musculoskeletal disorders

Николенко

Oganesyan

Vovkogon

et al. 2020

BMC Musculoskelet Disord

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Background Connective tissue dysplasia (CTD) is a risk factor for musculoskeletal disorders. Changes caused by disorganization of collagen and elastin fibers lead to the inability of withstanding heavy mechanical stress. In clinical practice, diagnosis of these disorders depends on physical and anthropomorphic evaluation. Methods Forty-eight patients with frequent post-exercise musculoskeletal disorders were evaluated for CTD. The control group included 36 healthy participants. Both groups were evaluated via therapeutic examination with assessment of anthropometric indicators and physical-physiological evaluation, surveying and gathering of anamnesis. Based on testing results, study participants were evaluated on CTD presence and risk factors. Results All experimental group patients had connective tissue dysplasia of moderate and severe degree, with a total score of 49.44 ± 13.1. Certain morphological characteristics showed prevalence, allowing to determine pathognomonic predictors of high predisposition to frequent post-exercise musculoskeletal disorders. Back pain (100%), asthenic syndrome and kyphotic spinal deformation (75%), high gothic palate, hypermobility of joints and the auricles, excessive elasticity (63%), varicose veins of the lower extremities (56%) and hemorrhoids (56%), changes in the shape of the legs and temporomandibular joint (50%) showed to be significant clinical factors indicating possible connective tissue dysplasia. Conclusions The presence of these diagnostically significant morphological signs of CTD in humans is a pathognomonic predictor of a high predisposition to frequent injuries. Their early detection helps promote proper appointment of adequate physical activity regimen and develop treatment for the underlying cause.

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Cardiac Tamponade in a Patient With Mixed Connective Tissue Disease

Cited by 7 publications

References 6 publications

Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2

Cardiac tamponade in a patient with autoimmune polyglandular syndrome type 2

Massive Hemorrhagic Pericardial Effusion With Cardiac Tamponade as Initial Manifestation of Mixed Connective Tissue Disease

Morphological signs of connective tissue dysplasia as predictors of frequent post-exercise musculoskeletal disorders

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