Pericardial involvement in systemic lupus erythematosus: current diagnosis and therapy

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect almost any organ system. Cardiac involvement is common and has been acknowledged as a primary cause of morbidity and mortality in patients with SLE. Pericarditis is the most common cardiovascular manifestation in SLE. In this review we present the current diagnosis and treatment of SLE-related pericardial involvement.

Angina pectoris bei einer jungen Frau mit Lupus erythematodes

“…Post-mortem-Untersuchungen haben gezeigt, dass in bis zu 72 % der SLE-Patienten eine Perikarditis histologisch nachweisbar war, auch wenn es nur in ca. 25 % der Fälle zu manifesten Symptomen kommt [3]. Eine SLE-assoziierte Myokarditis kann aufgrund des arrhythmogenen Potenzials fatale Konsequenzen für den Patienten haben.…”

Colchicine: a simple and effective treatment for pericarditis in systemic lupus erythematosus? A report of 10 cases

“…14 NSAIDs, especially aspirin, ibuprofen or indomethacin, can be helpful for mild cases of pericarditis and pericardial effusions. 2,6,9,18 However, the use of NSAIDs is controversial for SLE patients: NSAIDs may be contra-indicated because of renal insufficiency or interaction with other drugs and because of frequent cutaneous and allergic reactions, hepatotoxic effects, and aseptic meningitis, 19 whereas the association of NSAIDs and steroids may lead to complications with high gastrointestinal toxicity. As a consequence, only two patients in our series received high-dose aspirin with colchicine.…”

“…Other SLE clinical manifestations occurring simultaneously with pericarditis included arthritis (n ¼ 3), pleuritis (n ¼ 1) and cutaneous lesions (n ¼ 1). The median Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score for the 10 patients at pericarditis onset was 6 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

“…1,[3][4][5] The treatment of SLE pericarditis lacks consensus, but it relies on intensification of SLE treatment. 1,[6][7][8] Moderate to high doses of corticosteroids are commonly used, 1,8,9 and the use of other treatments, including immunosuppressive therapies or biotherapies, has been reported. 10,11 Colchicine, a potentially poisonous natural product extracted from plants of the genus Colchicum and from Gloriosa superba, has been used for several years for treating pericarditis in the general population.…”

Perikarditis im Rahmen rheumatologischer Erkrankungen – Was der Rheumatologe wissen sollte

“…"Adult onset Still's disease" 3-37 % [45] Morbus Behçet <5 % [46] Systemischer Lupus erythematodes Ca. 25 % symptomatisch >50 % asymptomatisch [47] Systemische Sklerose Perikarditis 1,9-9 % Perikarderguss 15-72 % [48] Eosinophile Granulomatose mit Polyangiitis Perikarderguss ca. 6-7 % [49] Granulomatose mit Polyangiitis Ca.…”