A rare case of Systemic Lupus Erythematosus presenting as acute myopericarditis with bilateral pleural effusions.

Indika Wettasinghe, Arjunar Elanko, Shiran Puthra, Asanka Ratnayake, Rajananthini Thambippillai, C. Ponnamperuma, Aflah Sadeekin, Suresh Mendis
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Abstract

Acute myopericarditis is a rare presentation in clinical practice with multiple aetiologies. Eventhough cardiac manifestations are known to be present in up to 50% of Systemic Lupus Erythematosus (SLE) patients, acute myopericarditis is an uncommon presentation, occurring in up to 1% of patients. Here we report a patient who presented with fever and pleuritic type chest pain and was managed as acute myopericarditis with bilateral exudative pleural effusions and later diagnosed to have SLE. The patients were initially treated with nonsteroidal anti-inflammatory drugs and later with steroids and hydroxychloroquine. Early diagnosis of myopericarditis and identification of the aetiology is essential to halt the progression of disease. Pericarditis due to Tuberculosis need to be excluded before starting steroids in the Sri Lankan setting.
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一例表现为急性心肌炎伴双侧胸腔积液的系统性红斑狼疮罕见病例。
在临床实践中,急性心肌炎是一种罕见的表现,有多种病因。尽管已知高达50%的系统性红斑狼疮(SLE)患者会出现心脏表现,但急性心肌炎却并不常见,发病率仅为1%。在此,我们报告了一名因发热和胸膜炎型胸痛而就诊的患者,该患者因急性心肌炎合并双侧渗出性胸腔积液而接受治疗,后被诊断为系统性红斑狼疮。患者最初接受了非甾体抗炎药物治疗,后来又接受了类固醇和羟氯喹治疗。心肌炎的早期诊断和病因鉴定对于阻止病情发展至关重要。在斯里兰卡,在开始使用类固醇之前,必须排除结核引起的心包炎。
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