A study of the frequency of pericardial and pleural effusions in scleroderma

Objective. To determine the frequency of pericardial and pleural effusions in scleroderma. Methods. Using a case-control format, patients with scleroderma and no know n cardiac disease were recruited. Echocardiograms and chest radiographs wer e performed. Age- and gender-matched controls had echocardiograms performed which were read by a cardiologist, blinded to the diagnosis. The medical r ecords of 60 other scleroderma patients were also reviewed. Results. Thirty-seven scleroderma subjects were recruited, of whom 18 had d iffuse disease. Only eight subjects with diffuse disease and five with limi ted scleroderma had normal echocardiograms compared to 20 of 37 controls (P < 0.1). Two had pericardial effusions, both with diffuse scleroderma, and none of the controls had effusions present. Pulmonary hypertension occurred in three with diffuse disease and no controls. A chart review of a further 60 patients with scleroderma was performed. Pleural effusions were identif ied in 7% (4/58) of the cohort of scleroderma patients and were more freque nt in diffuse disease (10%). A total of 17% (4/23) of diffuse and 4% (1/23) of limited scleroderma patients had evidence of pericardial effusions. Conclusions. Pericardial effusions do occur in scleroderma without evidence of clinical cardiac dysfunction and are more common in diffuse scleroderma , Pleural effusions in scleroderma occur less frequently, in 7%.