Document Type : Case Report


1 School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.

2 Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

3 Tabriz University of Medical Sciences, Tabriz, Iran.


Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder with multiple system involvements which
commonly affects the cardiovascular system. Although pericarditis and pericardial effusion are prevalent cardiac manifestations
in SLE, massive pericardial effusion as an initial presentation is unusual. We describe a 47-year-old woman who presented to
the hospital with a headache, dry cough, shortness of breath, and fatigue. According to the clinical, radiologic, echocardiographic
and laboratory rheumatologic test findings, SLE was diagnosed and treatment with prednisolone, hydroxychloroquine, and
mycophenolate mofetil was initiated. The patient improved clinically, and follow-up echocardiography showed a reduction in
the effusion volume compared with previous tests within the preceding 6 months. In patients with cardiopulmonary symptoms,
especially when other organ involvement is seen, screening for autoimmune systemic diseases such as SLE should be
considered. To achieve rapid recovery and prevent life-threatening complications, early diagnosis and treatment are essential.


Main Subjects