Cardiac tamponade as the debut of systemic lupus erythematosus in a young man

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which can affect any organ. The classic signs and symptoms generally consist of arthralgias, myalgias, photosensitivity and kidney failure. Almost half of the patients have heart abnormalities at some point in their disease, and cardiac tamponade is described as one of the late complications, being unusual as an initial presentation. We present the case of a 32-year-old man who consulted due to chest pain, dyspnea and lower extremity edema. An acute coronary syndrome was suspected, and an admission ultrasound showed evidence of cardiac tamponade, leading to emergency interventions which saved the patient’s life. Laboratory tests ruled out infectious causes, and high ANA and anti-DNA titers, along with clinical variables, led to a diagnosis of SLE. Immunomodulatory therapy was begun, and he was discharged from the hospital after 16 days