An Indonesian pregnant woman with systemic lupus erythematosus and cardiac tamponade: A case report

BACKGROUND: Systemic lupus erythematosus (SLE) during pregnancy with cardiac tamponade is a rare case. CASE PRESENTATION: A 33-year-old pregnant woman complained of worsening shortness of breath, hair loss, and joint pain. Laboratory investigation revealed the poor condition of the patient so therapeutic abortion was recommended. Transthoracic echocardiography confirmed cardiac tamponade and pericardiocentesis was performed. The ANA test showed a flare SLE and she was given immunosuppressant therapy. Repeat echocardiography demonstrated minimal pericardial effusion. The patient refused cyclophosphamide. Follow-up echocardiography evaluation at fifth-month revealed minimal pericardial effusion. However, patient refused to be hospitalized. DISCUSSION: A combination of pericardiocentesis and immunosuppressant therapy is an effective strategy to treat cardiac tamponade in pregnancy with SLE. CONCLUSION: Immunosuppressants and pericardiocentesis followed by cyclophosphamide are the cornerstones of management of SLE and cardiac tamponade in pregnant patients.