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Massive pericardial effusion causing cardiac tamponade accompanied by elevated CA-125 and thoracic lymphadenopathy in sarcoidosis: a case report

INTRODUCTION: Pericardial effusion and cardiac tamponade are rare manifestations of cardiac sarcoidosis. This is a first case report that describes a patient with severe pericardial effusion and signs of cardiac tamponade with elevated carbohydrate antigen 125 (CA-125) levels, enlarged pericardial (...

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Autores principales: Kudaiberdiev, Taalaibek, Tukusheva, Elmira, Gaibyldaev, Zhanybek, Tursunbekova, Gulnaz, Kadyraliev, Zhunus, Akhmedova, Irina, Tulopbergenov, Nurjan, Muraliev, Emil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306529/
https://www.ncbi.nlm.nih.gov/pubmed/32563820
http://dx.doi.org/10.1016/j.ijscr.2020.06.037
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author Kudaiberdiev, Taalaibek
Tukusheva, Elmira
Gaibyldaev, Zhanybek
Tursunbekova, Gulnaz
Kadyraliev, Zhunus
Akhmedova, Irina
Tulopbergenov, Nurjan
Muraliev, Emil
author_facet Kudaiberdiev, Taalaibek
Tukusheva, Elmira
Gaibyldaev, Zhanybek
Tursunbekova, Gulnaz
Kadyraliev, Zhunus
Akhmedova, Irina
Tulopbergenov, Nurjan
Muraliev, Emil
author_sort Kudaiberdiev, Taalaibek
collection PubMed
description INTRODUCTION: Pericardial effusion and cardiac tamponade are rare manifestations of cardiac sarcoidosis. This is a first case report that describes a patient with severe pericardial effusion and signs of cardiac tamponade with elevated carbohydrate antigen 125 (CA-125) levels, enlarged pericardial (PLN) and mediastinal lymph nodes (MLN), histologically confirmed as sarcoidosis. PRESENTATION OF CASE: A 51-year-old female patient was admitted with complaints of sickness, shortness of breath on minimal exertion, swelling in lower extremities, and heaviness in right upper abdomen. Patient had diminished heart sounds, peripheral edema and hepatomegaly. She had elevated CA-125 level without gynecologic pathology. There were QRS alternation on ECG and water-bottle configuration on chest-X-ray, severe pericardial effusion, and signs of cardiac tamponade on echocardiography. CT demonstrated massive pericardial effusion, pericardial mass and enlargement of anterior MLN. The patient underwent pericardial drainage with removal of 850 mL of pericardial fluid and excision of enlarged PLN. Histological examination of PLN revealed non-caseating epithelioid cell granulomas. The diagnosis of cardiac sarcoidosis was established. Patient was discharged and 6-month follow-up was uneventful. DISCUSSION: There are no reports on association of pericardial effusion, with increased CA-125 level in sarcoidosis, as we established in our patient. Our case is notable by incidental finding of enlarged PLN, mimicking pericardial mass and mediastinal lymphoadenopathy on CT, further confirmed by histological examination of PLN specimen as cardiac sarcoidosis. CONCLUSION: It should be kept in mind that sarcoidosis may present as massive pericardial effusion, with signs of tamponade and pericardial lymphoadenopathy mimicking pericardial mass, mediastinal lymphoadenopathy and elevated CA-125, mimicking malignancy.
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spelling pubmed-73065292020-06-25 Massive pericardial effusion causing cardiac tamponade accompanied by elevated CA-125 and thoracic lymphadenopathy in sarcoidosis: a case report Kudaiberdiev, Taalaibek Tukusheva, Elmira Gaibyldaev, Zhanybek Tursunbekova, Gulnaz Kadyraliev, Zhunus Akhmedova, Irina Tulopbergenov, Nurjan Muraliev, Emil Int J Surg Case Rep Article INTRODUCTION: Pericardial effusion and cardiac tamponade are rare manifestations of cardiac sarcoidosis. This is a first case report that describes a patient with severe pericardial effusion and signs of cardiac tamponade with elevated carbohydrate antigen 125 (CA-125) levels, enlarged pericardial (PLN) and mediastinal lymph nodes (MLN), histologically confirmed as sarcoidosis. PRESENTATION OF CASE: A 51-year-old female patient was admitted with complaints of sickness, shortness of breath on minimal exertion, swelling in lower extremities, and heaviness in right upper abdomen. Patient had diminished heart sounds, peripheral edema and hepatomegaly. She had elevated CA-125 level without gynecologic pathology. There were QRS alternation on ECG and water-bottle configuration on chest-X-ray, severe pericardial effusion, and signs of cardiac tamponade on echocardiography. CT demonstrated massive pericardial effusion, pericardial mass and enlargement of anterior MLN. The patient underwent pericardial drainage with removal of 850 mL of pericardial fluid and excision of enlarged PLN. Histological examination of PLN revealed non-caseating epithelioid cell granulomas. The diagnosis of cardiac sarcoidosis was established. Patient was discharged and 6-month follow-up was uneventful. DISCUSSION: There are no reports on association of pericardial effusion, with increased CA-125 level in sarcoidosis, as we established in our patient. Our case is notable by incidental finding of enlarged PLN, mimicking pericardial mass and mediastinal lymphoadenopathy on CT, further confirmed by histological examination of PLN specimen as cardiac sarcoidosis. CONCLUSION: It should be kept in mind that sarcoidosis may present as massive pericardial effusion, with signs of tamponade and pericardial lymphoadenopathy mimicking pericardial mass, mediastinal lymphoadenopathy and elevated CA-125, mimicking malignancy. Elsevier 2020-06-13 /pmc/articles/PMC7306529/ /pubmed/32563820 http://dx.doi.org/10.1016/j.ijscr.2020.06.037 Text en © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kudaiberdiev, Taalaibek
Tukusheva, Elmira
Gaibyldaev, Zhanybek
Tursunbekova, Gulnaz
Kadyraliev, Zhunus
Akhmedova, Irina
Tulopbergenov, Nurjan
Muraliev, Emil
Massive pericardial effusion causing cardiac tamponade accompanied by elevated CA-125 and thoracic lymphadenopathy in sarcoidosis: a case report
title Massive pericardial effusion causing cardiac tamponade accompanied by elevated CA-125 and thoracic lymphadenopathy in sarcoidosis: a case report
title_full Massive pericardial effusion causing cardiac tamponade accompanied by elevated CA-125 and thoracic lymphadenopathy in sarcoidosis: a case report
title_fullStr Massive pericardial effusion causing cardiac tamponade accompanied by elevated CA-125 and thoracic lymphadenopathy in sarcoidosis: a case report
title_full_unstemmed Massive pericardial effusion causing cardiac tamponade accompanied by elevated CA-125 and thoracic lymphadenopathy in sarcoidosis: a case report
title_short Massive pericardial effusion causing cardiac tamponade accompanied by elevated CA-125 and thoracic lymphadenopathy in sarcoidosis: a case report
title_sort massive pericardial effusion causing cardiac tamponade accompanied by elevated ca-125 and thoracic lymphadenopathy in sarcoidosis: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306529/
https://www.ncbi.nlm.nih.gov/pubmed/32563820
http://dx.doi.org/10.1016/j.ijscr.2020.06.037
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