[Pericarditis and pericardial effusion as the first presentation of systemic lupus erythematosus. Case report].

BACKGROUND

Acute pericarditis is rare in children; it can evolve to effusion or even cardiac tamponade. The main infectious agents are viruses and bacteria. The pharmacological treatment includes NSAIDs; just a few patients need pericardiocentesis.

CLINICAL CASE: A school-age patient was hospitalized because of chest pain; she was diagnosed with acute pericarditis and pericardial effusion, without any other symptoms. The disease pattern then evolved to dry cough, crushing epigastric abdominal pain, vomiting and fever. Due to a poor response to the initial treatment, immunological studies were requested. She tested positive to antinuclear antibodies (ANA), anti-double stranded DNA, direct Coombs and anticardiolipin antibodies; hypocomplementemia with lymphopenia was detected too, which is an indicative of systematic lupus erythematosus.

CONCLUSIONS

The torpid evolution or recurrence of pericarditis must direct toward excluding neoplastic or autoimmune bodies. Cardiovascular manifestations rarely appear initially in patients with systemic lupus erythematosus.