¹Shailesh Perdalkar, ¹Rohit Ravindra Dusane, ²Pooja Basthi Mohan

¹NMC Healthcare LTD, ²Kasturba Medical College

Purpose Statement: Systemic lupus erythematosus (SLE) is chronic systemic inflammatory condition. The clinical manifestations of SLE vary from minor joint and skin abnormalities to potentially fatal internal organ diseases.  Pericarditis is one of the common cardiac manifestations of SLE and it presents a diagnostic challenge due to the similarities with viral pericarditis. Accurate and prompt diagnosis is crucial  since misdiagnosis or delayed diagnosis can result in potentially dangerous consequences, such as persistent pericarditis and pericardial effusion. In this review, we intended to estimate the pooled prevalence of pericarditis in SLE, identify the risk factors and the outcomes of pericarditis in patients with SLE.

Method(s): On 25 February 2024, a systematic search of the literature was conducted using the PubMed and Medline databases.  The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The following search terms were used (“lupus erythematosus, systemic”[MeSH Terms] AND “Pericarditis”[MeSH Terms]) to search articles reporting the prevalence of pericarditis in patients with SLE. The primary objective of this review was to estimate the pooled prevalence of pericarditis in SLE patients, and the secondary objective was to identify the risk factors and the outcomes of pericarditis in SLE patient population. Using predetermined inclusion and exclusion criteria, two authors (SP and RRM) independently assessed the titles and abstracts of the identified references. Disagreements were settled by discussion and, if necessary, by consulting author PBM. The quality of the included references was assessed by the Newcastle-Ottawa scale.

Result(s): We identified a total of 11 studies reporting the prevalence of pericarditis in SLE patients involving 6800 patients. Considerable heterogeneity was observed in the included studies, as a result, the random-effects model was used for the meta-analysis. The pooled prevalence of pericarditis in SLE was found to be 16.1% [95% CI 12.7; 20.7]. Older age, active lupus disease, longer disease duration higher SLEDAI, renal disorder, high incidence of co-morbidities, high D-dimer, low C4, high ESR lymphocytopenia, thrombocytopenia and anti-phospholipid antibody (aPL) seropositivity were found to be the risk factors of pericarditis.

Conclusion(s): Our review provides the first pooled prevalence of pericarditis among individuals with  SLE and highlights some of the potential risk factors associated with this condition. Given the frequent occurrence of pericarditis in SLE it is important to emphasize prompt diagnosis and treatment to reduce the risk of further morbidity and mortality.