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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006927
  • Learning from errors

Cardiac tamponade as the first manifestation of systemic lupus erythematosus in children

  1. Mohamad Hassan Itani4
  1. 1Division of Clinical Services at Children's Heart Center, American University of Beirut Medical Center, Beirut, Lebanon
  2. 2Department of Pediatrics and Adolescent Medicine, American University Medical Center of Beirut, Beirut, Lebanon
  3. 3Department of Pediatrics, Rafik Hariri University Hospital, Beirut, Lebanon
  4. 4Department of Pediatrics, Beirut Arab University, Beirut, Lebanon
  1. Correspondence to
    Dr Mohamad Hassan Itani, hmitani@inco.com.lb

Summary

Systemic lupus erythematosus (SLE) is a serious chronic autoimmune disease with intense inflammatory response and damage in many target organs including joints, skin, kidneys, heart and nervous system. Cardiac tamponade is extremely rare as a cardinal presentation of SLE in children with only a few cases reported in the literature. We report two cases of a 9-year-old boy and an 11-year-old girl presenting with acute cardiac tamponade and later recognition of elevated anti-double-stranded DNA (anti-dsDNA) titre. We also present a literature review about similar cases in children and we stress on the importance of screening all cases of acute cardiac tamponade in children with antinuclear and anti-dsDNA antibodies to avoid any delay in SLE diagnosis and treatment.

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