Pericarditis in systemic lupus erythematosus: a series of clinical cases

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by polysyndromic lesions of various organs and systems. Clinical manifestations of SLE may include lesions of the skin, joints, kidneys, serous membranes, and hematopoiesis system, which significantly complicates the diagnosis and management of patients. This paper presents three clinical cases demonstrating the variety of manifestations and severity of the course of SLE. In the first case, the disease debuted with a massive hydropericardium, which required surgical intervention. In the second case, the patient was observed for a long time with autoimmune nephritis, but later developed pulmonary embolism, which required correction of therapy. The third case was characterized by high activity of the disease with polyserositis, pancytopenia and severe skin manifestations, which required the use of genetically engineered biological therapy (GIBP). In the presented cases, a comprehensive examination of patients was performed, including immunological markers, instrumental diagnostic methods (CT, ECHO-CS, biopsy), as well as a differential diagnosis with hemoblastosis, vasculitis and other systemic diseases. The treatment was based on glucocorticosteroids (GCS), cytostatics (cyclophosphamide) and biological therapy (rituximab), which made it possible to stabilize the condition of patients and reduce the activity of the disease. Thus, the presented clinical cases illustrate the significant variety of clinical manifestations and the complexity of the diagnosis of SLE, which emphasizes the need for a multidisciplinary approach to the management of such patients. Modern therapies, including GIBP, make it possible to control the activity of the disease and improve the prognosis of patients with severe forms of SLE.

1. Varavin N.A., Santakov A.A., Lapshina D.Y. A clinical case of systemic lupus erythematosus in the form of cardiac tamponade. Russian Journal of Cardiology. 2024;29(9S):32-33. (In Russ.) eLIBRARY ID: 74925005 EDN: TVUQMM

2. Belov B.S., Tarasova G.M. Pericarditis in rheumatology: modern clinical and diagnostic aspects and issues of therapy. Consilium Medicum. 2020;22(1):26-30. https://doi.org/10.26442/20751753.2020.1.200060

3. Guzmán-Martínez G, Marañón C; CYTED RIBLES Network. Immune mechanisms associated with cardiovascular disease in systemic lupus erythematosus: A path to potential biomarkers. Front Immunol. 2022;13:974826. https://doi.org/10.3389/fimmu.2022.974826

4. Tsokos G.C. Systemic lupus erythematosus. The New England Journal of Medicine. 2011;365(22). https://doi.org/10.1056/NEJMra110035