Abstract
A 76-year-old woman had visited our hospital with diabetes mellitus and hypertension. In 2007, urinary protein, antinuclear antibody, scleroderma, and pericardial effusion appeared. In January 2008, she was diagnosed with systemic sclerosis (SSc) by skin biopsy. Afterward, pericardial effusion was increasing gradually, and she was admitted to our hospital with pleural effusion, dyspnea, and systemic edema. She received pleural puncture to remove the effusion and additional diuretic was administered. Her symptoms improved and she was discharged. In April, she was admitted again because pericardial effusion and pleural effusion were increasing. Despite the pleural puncture and the increased-dose of diuretic, her pericaldial effusion was not improved, although the pleural effusion decreased. Prednisolone was initiated at 45 mg/day (1 mg/kg), and the pericardial effusion decreased. Three months later, her renal function worsened gradually and pericardial effusion increased again. She died of renal failure and heart failure. Although pericardial effusion and pericarditis are well-known complications of SSc, the symptoms caused by the pericardial effusion are rarely shown. Pericardial effusion is a prognostic factor preceding renal failure and renal crisis, and the effect of steroid is poor. We thought, through-out our case, a considerable condition that the steroid for pericardial effusion was effective temporarily and that pericardial effusion correlated with renal failure.
