Dorsa Kavandi - School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Majid Alikhani - Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Sepideh Tahsini Tekantapeh - Tabriz University of Medical Sciences, Tabriz, Iran.

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder with multiple system involvements whichcommonly affects the cardiovascular system. Although pericarditis and pericardial effusion are prevalent cardiac manifestationsin SLE, massive pericardial effusion as an initial presentation is unusual. We describe a 47-year-old woman who presented tothe hospital with a headache, dry cough, shortness of breath, and fatigue. According to the clinical, radiologic, echocardiographicand laboratory rheumatologic test findings, SLE was diagnosed and treatment with prednisolone, hydroxychloroquine, andmycophenolate mofetil was initiated. The patient improved clinically, and follow-up echocardiography showed a reduction inthe effusion volume compared with previous tests within the preceding 6 months. In patients with cardiopulmonary symptoms,especially when other organ involvement is seen, screening for autoimmune systemic diseases such as SLE should beconsidered. To achieve rapid recovery and prevent life-threatening complications, early diagnosis and treatment are essential.

SLE, massive pericardial effusion, echocardiography