Clinical Manifestation, Diagnosis, Management, and
Treatment Outcome of Pericarditis in Patients with
Systemic Lupus Erythematosus
Tanas Buppajarntham MD*,
Nattawan Palavutitotai MD*, Wanruchada Katchamart MD, MSc (Clin Epi)**
Affiliation :
*Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
**Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok, Thailand
Objective : To investigate the clinical manifestations, diagnosis, etiology, management, and outcomes of patients with systemic
lupus erythematosus (SLE) and pericarditis
Material and Method: The authors retrospectively reviewed the records of 81 patients who were diagnosed of SLE according
to the American College of Rheumatology criteria and had 82 episodes of pericarditis between 2002 and 2010. The diagnosis
of pericarditis was defined as the presence of pericardial effusion alone by echocardiography or having 2 out of 4 of the
following criteria: retrosternal pain, pericardial friction rub, widespread ST-segment elevation, and new/worsening
pericardial effusion.
Results : Most of them (92%) were female with the median disease duration (range) of 1 (0-312) month. Cardiac tamponade
occurred in 16% (95% CI 8.72-25.58%). There was no statistically significant difference between patients who developed
tamponade and those who did not. The causes of pericarditis included active SLE (93%), and suspected tuberculosis (TB)
(5%), with 2% inconclusive. In patients with lupus pericarditis, 71% had other active organ involvement. Most lupus
pericarditis patients (79%) had good response to steroid or NSAIDs. Diagnosis of TB pericarditis was made by clinical
suspicion without microbiological or pathological evidence.
Conclusion : In an endemic area of TB, lupus pericarditis was still the most common cause of pericarditis in SLE. Most
patients responded well to steroid.
Keywords : Systemic lupus erythematosus, Pericardial effusion, Pericarditis, Tuberculosis
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