Background and aims Systemic lupus erythematosus (SLE) is an autoimmune disease that has a variety of complications in all organs of the body. Pericardial effusion in the one manifestation SLE of the heart and an emergency nature. Massive pericardial effusion may result failure in cardiac pumping that is often referred to cardiac tamponade. Searching for the causes of pericardial effusion is required for diagnosis and therapy.

Methods A woman, 19 years old with complaints of chest pain and shortness of breath. Pale, joint pain, fever and weight loss.

On examination found tachycardia, pallor, muffled heart sounds, bilateral pleural effusions, and pretibial oedema.

Laboratories: Hb 8.6 g/dl, leukocytes 5900/mm³, Ht 27.7%, PLT 192,000/mm³, urea 97.9 mg/dl, creatinine 1,51 mg/dl, ferritin >2000 ng/ml, FE 17 mg/dl, TIBC 103 ug/dl, albumin 2.1 g/dl, 68.9 ANA test positive, Anti ds-DNA in 2754, CRP positive. Echocardiography showed massive pericardial effusion Φ 30.2 mm. Fluid analysis : reddish colour, pH 7.9, 0.178 × 103 WBC/uL, 0.005 × 106 RBC/uL, MN cells 36%, and 64% PMN cells.

Diagnosed was done SLE with massive pericardial effusion.

Therapy: pulse steroids and mmf. Antibiotic, diuretic, ACEi, deferoxamine and antipyretic. Patients do pericardiasynthesis.

Results After all therapy for 5 days of treatment, the patients showed clinical improvement where the shortness and chest pain were reduced, clinical symptoms improved, and pulse 90x/min. The patient is discharged with a follow-up plan every one moth.

Conclusions We reported a case of massive pericardial effusion young SLE patient. Patients receive immunosuppressive and also do pericardiasynthesis.