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AB0705 Pleuropericardial effusion, a rare presenting feature in patients with sarcoidosis – a case series
  1. C. Dharmapalaiah1,
  2. N. Hassan1,
  3. A. Nandagudi1,
  4. A. Bharadwaj1
  1. 1Rheumatology, Basildon and Thurrock university Hospital NHS Trust, Basildon, United Kingdom

Abstract

Background Pulmonary involvement is very common and occurs in up to 70% of patients with Sarcoidosis. However, Sarcoidosis presenting with pleural or pericardial effusion is very rare as per published series. Asymptomatic minimal pericardial effusion occurs in up to 20% of biopsy proven Sarcoidosis, while pleural involvement is seen only in about 1-5% of patients.

Objectives To highlight that pleural or pericardial effusion can be a presenting feature of sarcoidosis.

Methods We performed a retrospective review of 5 Caucasian patients case notes of with Sarcoidosis seen in one district general hospital, in Essex, UK. Pleuropericardial effusion seen on imaging at presentation was a common feature in all 5 patients. All patients presented with chest pain, shortness of breath and high acute phase response.

Results All 5 patients were seen by 1 consultant Rheumatologist between September 2010 and September 2011, 3 were admitted to the acute medical unit and 2 were seen in the outpatients. The age range was 34 to 61 years (median 55 years). Four were males and one female. All the patients presented with acute onset of pleuritic chest pain, dyspnoea, polyarthralgia and very high inflammatory markers. Echocardiogram showed pericardial effusion in 4 out of 5 patients, and pleural effusion and lymphadenopathy was present in all 5 patients’ CT scans (see table 1).

Conclusions Pleuropericardial effusion can be a presenting feature of Sarcoidosis as seen in our case-series. It should be considered as an important cause of shortness of breath in patients with Sarcoidosis.

  1. Angomachalelis N, Hourzamanis A, Salem N, Vakalis D, Serasli E, et al. Pericardial effusion concomitant with specific heart muscle disease in systemic sarcoidosis. Postgrad Med J. 1994;70:S8–S12

  2. Israel RH, Poe RH. Massive pericardial effusion in sarcoidosis. Respiration. 1994;61:176–180

  3. Cardiac sarcoidosis: a comprehensive review Arch Med Sci. 2011 August; 7(4): 546–554. vSilverman KJ, Hutchins GM, Buckley BH. Cardiac sarcoid a clinicopathologic study of 84 unselected patients with systemic sarcoidosis. Circulation. 1978;58:1204–11.

  4. Michael C. Iannuzzi, M.D., Benjamin A. Rybicki, Ph.D., and Alvin S. Teirstein, M.D. N ENGL J MED 2007; 357:2153-2165

  5. Moller DR: Rare manifestations of sarcoidosis. Eur Respir Monograph 2005, 10:233-250.

Disclosure of Interest None Declared

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