Concomitant Pericardial Effusion and Pulmonary Embolism Secondary to a Systemic Lupus Erythematosus with Antiphospholipid Antibody Syndrome: A Rare Case Report
Published: 2023-05-25
Page: 167-172
Issue: 2023 - Volume 6 [Issue 1]
H. Choukrani *
Cardiology Department, Ibn Rochd University Hospital, Morocco.
S. Abouradi
Cardiology Department, Ibn Rochd University Hospital, Morocco.
Y. Ettagmouti
Cardiology Department, Ibn Rochd University Hospital, Morocco.
Y. Hamine
Cardiology Department, Ibn Rochd University Hospital, Morocco.
K. Boumlik
Cardiology Department, Ibn Rochd University Hospital, Morocco.
R. Habbal
Cardiology Department, Ibn Rochd University Hospital, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Association of pulmonary embolism and pericardial effusion is rarely described in the literature, it is associated in the majority of cases with a neoplastic origin followed by a tuberculous origin. Within the limits of our research, no cases of lupus associated with antiphospholipid syndrome have been reported.
Case Report: We illustrate a case of a 25-year-old patient, presenting with respiratory discomfort and palpitations and in whom echocardiography shows a pericardial tamponade. The realization of athoracic CT angiography shows a concomitant pulmonary embolism. The etiological assessment poses the diagnosis of systemic lupus erythematosus (SLE) associated to antiphospholipid antibody syndrome.
Conclusions: Pulmonary embolism and pericardial effusion can be life-threatening for the patient. This association highlights a difficult clinical dilemma with regard to anticoagulation in the presence of pericardial effusion, which remains a relative contraindication to anticoagulation.
Keywords: Pericardial effusion, pericardial tamponade, pulmonary embolism, systemic lupus erythematosus, antiphospholipid antibody syndrome
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References
Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, et al. ESC Guidelines for the diagnosis and management of pericardialdiseases: The Task Force for the Diagnosis and Management of PericardialDiseases of the European Society of Cardiology (ESC) Endorsed by: The European Association for Cardio-ThoracicSurgery (EACTS). EurHeart J 2015;36:2921–4.
Rogers MA, Levine DA, Blumberg N, Flanders SA, Chopra V, Langa KM. Triggers of hospitalization for venous thrombo embolism. Circulation. 2012; 125(17):2092-9.
Baragé A, Harouna Idrissa S, Mahoungo Mackoniab N, Arous S, Bennouna G, Azzouzi L, Habbal R. Cardiac tamponade: Better prognosis in association with pulmonary embolism: Case report Annals of Medicine and Surgery. 2021;66:102410
Akhbour S, Khennine BA, Oukerraj L, Zarzur J, Cherti M. Pericardial tamponade and coexisting pulmonary embolism as first manifestation of non-advanced lung adenocarcinoma. Pan Afr Med J. 2014;18.
Sebastian Słomka, Piotr Lipiec. Acute pulmonary embolism following cardiac tamponade. Biomed J Sci & Tech Res. 2023;49(5). BJSTR. MS.ID.007863.
Jairath UC, Benotti JR, Spodick DH. Cardiac tamponade masking pulmonary embolism. Clin Cardiol. 2001;24(6): 485–6.
Khan MU, Khouzam RN. Protective effect of pulmonary hypertension against right-sided tamponade in pericardial effusion South Med J. Janv. 2015; 108(1):46-48.
McLaughlin M, Ganz P, Durstenfeld M, Hsue P. An unusual case of pulmonary hypertension and pericardial effusion circulation. 2021;144:A12913.
Anis Ta’eed, Ai-Ming Wong, John Mulder, Yang Yang. How bad can life be? A case of concurrent cardiac tamponade and pulmonary embolus. AJUM. 2020;23:140-143.
Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. European league against rheumatism/american college of rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol. 2019;71:1400–12.
Alana M. Nevares. Professional, musculoskeletal and connective tissue disorders, autoimmune rheumatic diseases, systemic lupus erythematosus ; 2022.
Systemic lupus and antiphospholipid syndrome. National Reference Center for LUPUS and Antiphospholipid Syndrome, Pitie Salpetriere Aphp.
Cohen H, et al. 16th International Congress on Antiphospholipid Antibodies Task Force Report on Antiphospholipid Syndrome Treatment Trends. Lupus. 2020;29(12): 1571-1593.