Pericardial tamponade complicating systemic lupus erythematosus

We describe a case of pericardial tamponade as an initial manifestation of late onset systemic lupus erythematosus (SLE). Tamponade is uncommon in SLE, but when it occurs, it is usually during the initial presentation of the patient. The occurrence of tamponade in patients with SLE with pericarditis is unpredictable, but usually associated with radiographic evidence of cardiomegaly. Treatment consists of pericardiocentesis, administration of high dose glucocorticoids and drainage via pericardial catheter. Recognition of this rare manifestation of SLE may be life saving.