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Urgent pericardiocentesis relieved her acute symptoms, and prompt treatment with thyroxine replacement and immunosuppression for lupus disease was initiated. Pericardial fluid analysis remained negative for any malignancy and\/or infection\/s. The patient had a gradual and consistent improvement with this treatment. She was discharged and appeared to be clinically stable at subsequent follow-up visits. However, the case remained a diagnostic dilemma over whether the tamponade was being driven by hypothyroidism versus lupus, leaving us with an opportunity to explore further.<\/jats:p>","DOI":"10.1136\/bcr-2014-206095","type":"journal-article","created":{"date-parts":[[2015,3,6]],"date-time":"2015-03-06T08:26:28Z","timestamp":1425630388000},"page":"bcr2014206095","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["SLE or hypothyroidism: who can triumph in cardiac tamponade?"],"prefix":"10.1136","volume":"2015","author":[{"given":"Sameer Sadashiv","family":"Chaudhari","sequence":"first","affiliation":[{"name":"Department of Cardiology, Newark Beth Israel Medical Center, Newark, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kashmira Pramod","family":"Wankhedkar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Metropolitan Hospital Centre, New York, New 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