New Onset Systemic Lupus Erythematosus Presenting with Massive Pericardial Effusion: A Case Report

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 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.