Clinical introduction

A 21-year-old female patient was admitted to the emergency department with a 1-month history of dyspnoea increasing over the last few days. Transthoracic echocardiogram demonstrated a massive pericardial effusion reaching 2.1 cm at its widest with right ventricular outflow tract diastolic collapse (). Urgent fluoroscopy-guided pericardiocentesis via the subxiphoid approach was performed. A total of 1000 cc of milky fluid was removed (). The laboratory results of the fluid revealed a triglyceride level of 592 mg/dL and an Lactate Dehydrogenase (LDH) level of 392 U/L. On physical examination, a swollen puffy face, jugular venous distention, and venous collaterals along the chest and abdomen were observed (). She had nodular, erythematous painful eruption on the lower legs and history of recurrent oral aphthae. Further clinical and laboratory analyses, including Purified Protein Derivative (PPD) test, serum adenosine deaminase, antidouble-stranded DNA and antinuclear antibody, were unremarkable. A contrast-enhanced CT was performed…

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