Calcified constrictive pericarditis resulting in tamponade in a patient with systemic lupus erythematosus

Pieta, Antigone; Pelechas, Eleftherios; Gerolymatou, Nafsika; Drosos, Alexandros A.

doi:10.1007/s00296-020-04747-6

Cited by 4 publications

(2 citation statements)

References 49 publications

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“…Systemic lupus erythematosus is an autoimmune and inflammatory connective tissue disease that involves multiple organs [ 11 ]. Stimulation by estrogen, genetic, environmental, infectious, and endocrine factors leads to a decrease in T lymphocytes and a proliferation of B cells, which is consequently associated with the direct binding of autoantibodies to the tissue cells and subsequent local tissue damage and inflammatory reactions [ 12 ]. Currently, glucocorticoids are the main drug for the treatment of the disease [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Gandakang Tablets plus Methylprednisolone in Patients with Systemic Lupus Erythematosus

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To evaluate the clinical efficacy of Gandakang tablets plus methylprednisolone in patients with systemic lupus erythematosus (SLE). Methods. From February 2015 to February 2019, 60 eligible patients with SLE were recruited and assigned via the random number table method at a ratio of 1 : 1 to receive either methylprednisolone (control group) or Gandakang tablets plus methylprednisolone (observation group). The primary endpoint was clinical efficacy, and the secondary endpoints included Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, immunoglobulin (Ig), inflammatory factor levels, and adverse events. Results. Gandakang tablets plus methylprednisolone were associated with a significantly higher treatment efficacy versus methylprednisolone alone ( P < 0.05 ). Gandakang tablets plus methylprednisolone resulted in significantly lower SLEDAI scores and lower levels of IgG, IgM, IgA, tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), and interleukin-6 (IL-6) versus single medication of methylprednisolone ( P < 0.05 ). The two groups showed a similar incidence of adverse events ( P > 0.05 ). Patients given Gandakang tablets plus methylprednisolone had higher mental health, emotional role, physical role, social functioning, and bodily pain scores versus those receiving the monotherapy of methylprednisolone ( P < 0.05 ). Conclusion. Gandakang tablets plus methylprednisolone is effective in the treatment of SLE by enhancing the patients’ immunity, mitigating the inflammatory response, eliminating negative emotions, and improving their quality of life.

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Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Gandakang Tablets plus Methylprednisolone in Patients with Systemic Lupus Erythematosus

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…In Sjögren’s syndrome, cardiac involvement is rare and usually asymptomatic [ 19 ]. Constrictive pericarditis is a rare finding in these conditions and can be a complication of indolent and subclinical pericardial involvement [ 5 , 6 , 20 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

Chronic constrictive pericarditis: a rare cardiac involvement in primary Sjögren’s syndrome

Duarte,

Oliveira,

Fontes

et al. 2023

BMC Cardiovasc Disord

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Background Constrictive pericarditis represents a chronic condition and systemic inflammatory diseases are a known, yet uncommon, cause. Pericardial involvement is seldom reported in primary Sjögren’s syndrome, usually occurring in association with pericardial effusion or pericarditis. We report a case of constrictive pericarditis with an insidious course and unusual evolution associated with primary Sjögren’s syndrome. Due to the challenging nature of the diagnosis, clinical suspicion and multimodality imaging are essential for early identification and prompt initiation of treatment. Long-term outcomes remain uncertain. To the best of our knowledge, no other cases linking this autoimmune disease to constrictive pericarditis have been reported. Case presentation We present the case of a 48-year-old male patient with moderate alcohol habits and a history of two prior hospitalizations. On the first, the patient was diagnosed with primary Sjögren’s syndrome after presenting with pleural effusion and ascites, and empirical corticosteroid regiment was initiated. On the second, two-years later, he was readmitted with complaints of dyspnea and abdominal distension. Thoracic computed tomography revealed a localized pericardial thickening and a thin pericardial effusion, both of which were attributed to his rheumatic disease. A liver biopsy showed hepatic peliosis, which was considered to be a consequence of glucocorticoid therapy. Diuretic therapy was adjusted to symptom-relief, and a tapering corticosteroid regimen was adopted. Four years after the initial diagnosis, the patient was admitted again with recurrent dyspnea, orthopnea and ascites. At this time, constrictive pericarditis was diagnosed and a partial pericardiectomy was performed. Although not completely asymptomatic, the patient reported clinical improvement since the surgery, but still with a need for baseline diuretic therapy. Conclusion Albeit uncommon, connective tissue disorders, such as primary Sjögren’s syndrome, should be considered as a potential cause of constrictive pericarditis, especially in young patients with no other classical risk factors for constriction. In this case, after excluding possible infectious, neoplastic and autoimmune conditions, a primary Sjögren´s syndrome in association with constrictive pericarditis was assumed. This case presents an interesting and challenging clinical scenario, highlighting the importance of clinical awareness and the use of multimodal cardiac imaging for early recognition and treatment.

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Systemic Lupus Erythematosus

Pelechas,

Kaltsonoudis,

Voulgari

et al. 2023

Illustrated Handbook of Rheumatic and Musculo-Skeletal Diseases

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Calcified constrictive pericarditis resulting in tamponade in a patient with systemic lupus erythematosus

Cited by 4 publications

References 49 publications

Clinical Efficacy of Gandakang Tablets plus Methylprednisolone in Patients with Systemic Lupus Erythematosus

Clinical Efficacy of Gandakang Tablets plus Methylprednisolone in Patients with Systemic Lupus Erythematosus

Chronic constrictive pericarditis: a rare cardiac involvement in primary Sjögren’s syndrome

Systemic Lupus Erythematosus

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