PERICARDITIS Y DERRAME PERICÁRDICO COMO PRESENTACIÓN INICIAL DE LUPUS ERITEMATOSO SISTÉMICO. REPORTE DE UN CASO PEDIÁTRICO.

Vilma Gerardo Morales, Eduardo Llausas Magaña, Angel Rito León Ramírez, Juan Manuel Carreón Guerrero, José Antonio Quibrera Matienzo, Miguel García Dominguez, Giordano Pérez Gaxiola

Resumen


La pericarditis aguda es una patología poco frecuente en pediatría, la cual se ve asociada a entidades autoinmunes como Lupus Eritematoso Sistémico en un 28%, siendo el síntoma inicial  sólo en 7.7%.Presentamos el caso de una paciente escolar ingresada a hospital por dolor torácico, con antecedente de fiebre y reactantes de fase aguda positivos, diagnosticada por ecocardiografía con derrame pericárdico, sin otra sintomatología clínica; se manejó con AINES y pericardiocentesis. Sin embargo, a las 48 horas inició nuevamente con dolor precordial; se descartaron causas infecciosas. Nuevo ecocardiograma visualiza reaparición del derrame pericárdico, con inicio de corticoides sin mejoría. Se realizó abordaje inmunológico con positividad a anticuerpos para LES, con posterior uso de inmunosupresor con buena respuesta, fué posible su egreso. Ante la presencia de evoluciones tórpidas o recurrencias de la pericarditis es necesario en todo paciente descartar causas autoinmunes.


Palabras clave


Pericarditis, derrame pericárdico, Lupus Eritematoso Sistémico, pediatría.

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DOI: http://dx.doi.org/10.29262/ram.v65i1.528

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