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© 1995 British Society for Rheumatology

research-article

MASSIVE PERICARDIAL EFFUSION IN SCLERODERMA: A REVIEW OF FIVE CASES

M. SATOH, M. TOKUHIRA, N. HAMA, M. HIRAKATA, M. KUWANA, M. AKIZUKI, Y. ICHIKAWA, S. OGAWA* and M. HOMMA

Division of Rheumatology, Keio University School of Medicine Tokyo, Japan
*Division of Cardiology, Department of Internal Medicine, Keio University School of Medicine Tokyo, Japan

Correspondence to: Correspondec to: M. Satoh, Division of Rheumatology and Immunology, Department of Medicine, The University of North Carolina at Chapel Hill, CB # 7280, 3330 Dor J Thurston Jr Bldg, Chapel Hill, NC 27599-7280, USA.

Medical records of five patients with sclerodenna (SSc), each of whom had pericardial effusion with an estimated volume of more than 200 ml, were reviewed to study the clinical and immunological significance of massive pericardial effusion in SSc. Diffuse SSc (4/5), with a wide area of pigmentation (4/5), flexion contracture (4/5), oesophageal hypomotility (5/5), pulmonary fibrosis (4/5) and autoantibodies to topoisomerase I (3/5) were the common features in this group. High protein, lactate dehydrogenase and low white blood cell count were the characteristics of pericardial fluid. None of the patients had signs of acute pericarditis. Four of the five cases died within 9 months of the diagnosis of pericarditis; two with renal failure, one with cardiac tamponade and another with sudden death. The pericarditis in diffuse SSc, especially in cases with anti-topoisomerase I, may be characterized by a chronic form of pericarditis with poor prognosis, often complicated by ,renal failure.

KEY WORDS: Scleroderma, Pericardial effusion, Antitopoisomerase I antibodies, Antinuclear antibodies, Renal failure


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