Candida pericarditis and tamponade in a patient with systemic lupus erythematosus

Candida pericarditis and tamponade developed in a patient with sterile purulent pericarditis secondary to systemic lupus erythematosus. Therapy with amphotericin B and properly timed surgical intervention led to a clinical and microbiological cure. This article emphasizes the importance of differentiating an infected pericardial effusion from the sterile pericarditis of systemic lupus erythematosus and provides suggested guidelines for the management of that complication.     

Gonococcal endocarditis in a patient with systemic lupus erythematosus

There is mounting evidence that patients with systemic lupus erythematosus (SLE) are prone to disseminated neisserial infections. We describe the first proven case of gonococcal endocarditis affecting the pulmonary valve in a patient known to have SLE. The clinical clues and pitfalls in diagnosis are discussed, and the role of echocardiography is highlighted. Possible reasons for the association of gonococcal endocarditis with SLE include pre-existing Libman. Sacks endocarditis, complement deficiency and abnormalities of the reticuloendothelial system.      

Intravenous immunoglobulin in treatment of cardiac tamponade in a patient with systemic lupus erythematosus

We describe a 23-year-old female patient with a history of systemic lupus erythematosus and pulmonary hypertension who developed a large pericardial effusion with cardiac tamponade. Invasive interventions such as pericardial window or pericardiectomy were ruled out because of the posterior localization of the effusion and high risk of general anesthesia in a patient with severe pulmonary hypertension. The patient received high-dose steroids intravenously with no response. A 5-day course of intravenous immunoglobulin resulted in gradual decrease of the pericardial effusion and resolution of cardiac tamponade within 2 weeks.     

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.     

Influenza virus B-associated hemophagocytic syndrome and recurrent pericarditis in a patient with systemic lupus erythematosus

Abstract

We report a 24-year-old male with systemic lupus erythematosus (SLE) who developed influenza virus B-associated hemophagocytic syndrome and cardiac tamponade. Although the patient’s general condition improved after steroid pulse therapy and pericardiocentesis, pericardial effusion re-accumulated. Colchicine and aspirin were administered, together with prednisolone, after which no further relapses occurred. This was a rare case of severe influenza-associated hemophagocytic syndrome and steroid-resistant pericardial effusion in an SLE patient.     

Dyspnea in a patient with systemic lupus erythematosus

A 33-year-old woman with a previous history of systemic lupus erythematosus complained of exerptional dyspnea and pleuritic chest pain accompanied by polyarthritis. Chest-X-rays revealed an elevation of the right hemidiaphragm. We discuss the diagnostic and therapeutic approach.     

Resolution of cardiac tamponade in systemic lupus erythematosus with indomethacin

Although in SLE pericarditis is common, cardiac tamponade is rare and its usual treatment has been effusion drainage. A 19-year-old girl presenting with cardiac tamponade was diagnosed with SLE. Treatment with indomethacin rapidly reduced the hemodynamic compromise, avoiding the need for pericardiocentesis.     

Burkitt's lymphoma in a patient with systemic lupus erythematosus

Patients with systemic lupus erythematosus (SLE) appear to be at increased risk for development of neoplastic disease. We describe the case of a male teenager with SLE and Burkitt's lymphoma. His presentation was similar to that of an exacerbation of his underlying SLE. We believe this to be the first case of Burkitt's lymphoma in a patient with SLE. The association of SLE and malignancy, with emphasis on lymphoproliferative states, is discussed.     

Legionnaires' disease in a patient with systemic lupus erythematosus

A young woman with systemic lupus erythematosus developed a rapidly fatal pneumonia from which no visible or culturable organisms were found. Subsequent stains disclosed typical findings of Legionnaires' disease. A cutaneous portal of entry was suspected and a fulminant lung abscess developed, neither of which has been previously reported in Legionnaires' disease.     

Rosai-Dorfman disease in a patient with systemic lupus erythematosus

Rosai-Dorfman disease (RDD), also known as sinus histocytosis with massive lymphadenopathy, is a clinically benign, frequently chronic, painless lymphadenopathy. It can also involve extranodal sites. We describe a 37-year-old man with a recent diagnosis of systemic lupus erythematosus and antiphospholipid antibody syndrome who had lacrimal gland and orbital involvement and nodal and extranodal sites with RDD.     

Anorexia nervosa in a patient with systemic lupus erythematosus

Summary Anorexia nervosa has not been described in patients with systemic lupus erythematosus (SLE). The case of a patient with SLE who developed the classical features of anorexia nervosa is described. Although an impressive interplay between psychosocial and cultural factors was present, the possibility that this syndrome was produced by active CNS vasculitis remained.