Sarcoidosis Manifested as Recurrent Pericardial Effusion with Signs of ImpendingTamponade

Abstrak

Pericardial effusion is a fatal and life-threatening condition. If it is not addressed
thoroughly, complications such as constrictive pericarditis may occur. Etiologies of
pericardial effusion varied and one of the most common etiologies is tuberculosis.
Other etiologies include inflammation, malignancy or other autoimmune disorder
such as sarcoidosis. Sarcoidosis is a diagnosis of exclusion and is confirmed by
biopsy result that showed non-caseating epitheloid-cell granuloma, with no other
organism or particles. Epidemiology of sarcoidosis in Japan is 1-2 case per 100.000
patients, with the peak incidence between the age of 20 to 39 years old. We reported
a case of 37 years old woman presented to our emergency department with
shortness of breath and signs of pericardial tamponade. She was previously healthy
with no other significant past medical. She was first treated as a case of
extrapulmonary tuberculosis and shown no improvement with anti-tuberculosis
medications. Several work ups were then done in search of other etiologies of her
pericardial effusion. A biopsy form one of her abdominal lymph nodes was
performed, which pathologically revealed sarcoidosis. She was placed on
corticosteroid and methotrexate with improvement of symptoms. One month
followed up showed complete resolution of her pericardial effusion.