{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:23Z","timestamp":1787013743761,"version":"build-2736575974"},"reference-count":103,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,12,10]],"date-time":"2016-12-10T00:00:00Z","timestamp":1481328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To describe the clinical characteristics, treatment and outcome of patients with systemic sclerosis (\n                      <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>\n                      c) developing severe pericardial effusion or cardiac tamponade.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>\n                      c patients with severe pericardial effusion or cardiac tamponade from three Spanish hospitals were collected. In addition, a computer\u2010assisted (PubMed,\n                      <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\n                      ) search of the literature to identify all cases of cardiac tamponade or severe pericardial effusion associated with\n                      <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>\n                      c reported in English, French and Spanish from 1987 through September 2015 was performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 40 patients (nine cases from the Spanish hospitals and 31 cases from the literature review). Most patients (87%) were female with a mean age at pericardial involvement of 49.3 \u00b1 15.2 years (range: 18\u201380 years), and 22 (55%) patients had the diffuse cutaneous subtype. Twenty\u2010five (63%) patients presented with cardiac tamponade and the remaining 15 (37%) as severe or massive pericardial effusion. Pericardial involvement was previous or simultaneous to\n                      <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>\n                      c diagnosis in 13 (32.5%) cases. In most cases (88.9%) pericardial fluid analysis disclosed an exudate. Half the patients received steroids and 35% needed surgical treatment. Five (12.5%) patients died due to cardiac tamponade, three of them during the acute phase and the remaining two, 2 and 9 months later, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Although cardiac tamponade or severe pericardial effusion is an infrequent complication in\n                      <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>\n                      c patients, it can be the first manifestation of disease associated with the diffuse cutaneous subset. No specific treatment for this complication is known.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.12952","type":"journal-article","created":{"date-parts":[[2016,12,10]],"date-time":"2016-12-10T07:58:56Z","timestamp":1481356736000},"page":"1582-1592","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Cardiac tamponade and severe pericardial effusion in systemic sclerosis: report of nine patients and review of the literature"],"prefix":"10.1111","volume":"20","author":[{"given":"Alejandro","family":"Fern\u00e1ndez Morales","sequence":"first","affiliation":[{"name":"Department of Autoimmune Diseases Hospital Clinic Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerea","family":"Iniesta","sequence":"additional","affiliation":[{"name":"Department of Autoimmune Diseases Hospital Clinic Barcelona 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