Clinical Pearls

Acute pericarditis is characterized by pleuritic chest pain, a pericardial friction rub. and ECG findings of diffuse ST elevation and PR depression.

Pericardial friction rub does not exclude a pericardial effusion; patients with acute pericarditis should be monitored for development of effusion and tamponade.

Treatment of pericarditis is directed at the underlying cause; for example, for uremic pericarditis, urgent dialysis is necessary. For viral or inflammatory causes, treatment is nonsteroidal antiinflammatory drugs or corticosteroids for refractory cases.

Systemic lupus erythematosus can be diagnosed if a patient has four of the following features: malar rash, discoid rash, photosensitivity, oral ulcers, arthritis, serositis, renal disease, neurologic manifestations, hematologic cytopenias, immunologic abnormalities (e.g., false-positive Venereal Disease Research Laboratory [VDRL| test), and positive antinuclear antibody.

The major morbidity and mortality of systemic lupus erythematosus are consequences of renal disease, central nervous system involvement, or infection.

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