Abstract
A 53-year-old woman suffered from a dry cough and dyspnea in Jan. 1987. On the basis of Raynaud's phenomenon, proximal sclerosis, pigmentation and depigmentation of skin, bone resorption at the finger tips, dilation of the esophagus, pulmonary hypertension and pulmonary fibrosis, she was diagnosed as having progressive systemic sclerosis (PSS). In Feb. 1991, fever and sputum appeared, and the cough and dyspnea became severe. A friction rub appeared and the Velcro rales worsened. Laboratory data showed arterial hypoxemia, leukocytosis, positive anti-nuclear antibody, positive anti-Scl-70 antibody and circulating immune complexes. Serum complement levels were normal, and anti-centromere antibody, anti-DNA antibody and anti-RNP antibody were all negative. Chest X-ray, UCG and CT revealed a marked pericardial effusion as well as pulmonary hypertension and fibrosis. She was treated with prednisolone, besides receiving oxgen, diuretics, a calcium antagonist and digitalis.
Although massive pericardial effusion associated with PSS is thought to bo rare and indicates a poor prognosis, nonsurgical treatment was thought to have been effective in our case.
