Pericardial effusion - systemic lupus erythematosus

Case contributed by Mahomed A. Osman
Diagnosis certain

Presentation

Systemic Lupus Erythematosis

Patient Data

Gender: Female

There is a globular shaped enlargement of the heart suggestive of pericardial effusion. Bilateral blunting of the costophrenic angles consistent with small bilateral pleural effusions. Air space opacity in the left lower lobe suggests consolidation or collapse.

There is a large global pericardial effusion. Small bilateral pleural effusions. Small areas of atelectasis in both lung bases. The pleura is thickened in the left posterior chest wall. There are increased interstitial markings in both lung bases, most pronounced in the lingula. This reflects a degree of pulmonary fibrosis.

Case Discussion

This patient went on to have a pleurodesis, with biopsies of the pericardium, lingula and pleura. The pathology report reads as follows:

Lingular wedge  biopsy and left  pleural biopsy -  fibrosing pleuritis consistent with SLE.

Parietal pericardium - chronic inflammation and fibrosis.

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