{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T23:43:54Z","timestamp":1778024634759,"version":"3.51.4"},"reference-count":19,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with rare but severe cardiac manifestations, including myocarditis and pericarditis. The coexistence of SLE with sickle cell trait (SCT), an inherited hemoglobinopathy prevalent among individuals of African descent, is exceptionally rare and presents significant diagnostic challenges due to overlapping clinical features. Objective: To describe the case of an Afro-Ecuadorian male with SLE and sickle cell trait who developed an uncommon presentation of myopericarditis and pericardial effusion. Case report: A 48-year-old African American male with no prior medical history presented with persistent fever, polyarticular arthralgias, and pleuritic chest pain. Investigations revealed sickle cell trait (SCT) and myopericarditis with pericardial effusion, marking the initial manifestation of SLE. Diagnostic delays occurred due to overlapping symptoms and a family history of sickle cell disease. Laboratory findings showed elevated hemoglobin S (&lt;50%), positive ANA (1:1280, coarse speckled pattern), and anti-Smith\/RNP antibodies, meeting EULAR\/ACR 2019 criteria for SLE. Cardiac MRI confirmed myopericarditis. Treatment with pulse methylprednisolone, oral prednisone, and mycophenolate mofetil resulted in clinical improvement, with stable disease control on immunomodulatory therapy during follow-up. Conclusions: This case highlights the diagnostic complexity of SLE in patients with SCT, particularly when presenting with myopericarditis as the initial manifestation. It emphasizes the importance of a comprehensive diagnostic approach and timely initiation of immunosuppressive therapy to optimize clinical outcomes. This report broadens the understanding of overlapping syndromes involving SLE and SCT.<\/jats:p>","DOI":"10.3390\/jcm14030920","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T11:42:37Z","timestamp":1738237357000},"page":"920","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Myopericarditis and Pericardial Effusion as the Initial Presentation of Systemic Lupus Erythematosus in a Patient with Sickle Cell Trait: A Case Report"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8445-7256","authenticated-orcid":false,"given":"Marlon","family":"Rojas-Cadena","sequence":"first","affiliation":[{"name":"Medical Science Faculty, Universidad Cat\u00f3lica del Ecuador, Quito 170525, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Rodr\u00edguez-Arcentales","sequence":"additional","affiliation":[{"name":"Medical Science Faculty, Universidad Cat\u00f3lica del Ecuador, Quito 170525, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Narv\u00e1ez-Cajas","sequence":"additional","affiliation":[{"name":"Medical Science Faculty, Universidad Cat\u00f3lica del Ecuador, Quito 170525, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3717-383X","authenticated-orcid":false,"given":"Marlon","family":"Arias-Intriago","sequence":"additional","affiliation":[{"name":"Department Section of Histology, Faculty of Medical Science, Universidad Central del Ecuador, Quito 170402, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Morales Orbe","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Am\u00e9ricas, Quito 170521, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-0546","authenticated-orcid":false,"given":"Juan S.","family":"Izquierdo-Condoy","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Am\u00e9ricas, Quito 170521, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/rheumatology\/kex286","article-title":"The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults","volume":"57","author":"Gordon","year":"2018","journal-title":"Rheumatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1093\/rheumatology\/kex260","article-title":"The worldwide incidence and prevalence of systemic lupus erythematosus: A systematic review of epidemiological studies","volume":"56","author":"Rees","year":"2017","journal-title":"Rheumatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.rdc.2013.10.003","article-title":"Cardiac Manifestations of Systemic Lupus Erythematosus","volume":"40","author":"Miner","year":"2014","journal-title":"Rheum. Dis. Clin."},{"key":"ref_4","unstructured":"Dein, E., Douglas, H., Petri, M., Law, G., and Timlin, H. (2024, December 02). Pericarditis in Lupus. Available online: https:\/\/www.cureus.com\/articles\/12198-pericarditis-in-lupus."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Iki\u0107 Matija\u0161evi\u0107, M., Grubi\u0107 Rotkvi\u0107, P., Planini\u0107, Z., Iki\u0107, L., Zadro Kordi\u0107, I., and Gali\u0107, E. (2023). Perimyocarditis as First Manifestation of Systemic Lupus Erythematosus Successfully Treated with Heart Failure and Immunosuppressive Therapy. J. Cardiovasc. Dev. Dis., 10.","DOI":"10.20944\/preprints202301.0452.v1"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1186\/1752-1947-6-366","article-title":"Systemic lupus erythematosus associated with sickle-cell disease: A case report and literature review","volume":"6","author":"Maamar","year":"2012","journal-title":"J. Med. Case Rep."},{"key":"ref_7","unstructured":"Das, D.S., and Sahoo, D. (2024, December 16). Coevality of Systemic Lupus Erythematosus with Sickle Cell Trait: A Not So Uncommon Entity. Available online: https:\/\/www.cureus.com\/articles\/29319-coevality-of-systemic-lupus-erythematosus-with-sickle-cell-trait-a-not-so-uncommon-entity."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Das, D.S. (2024). Case Report: Crosstalk between systemic lupus erythematosus and sickle cell syndromes\u2014Two cases from eastern India. Front. Lupus, 2.","DOI":"10.3389\/flupu.2024.1484352"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Dom\u00ednguez, Y., Zurita, C., Calvopi\u00f1a, D., Villac\u00eds, J., and Mora, M. (2013). Prevalence of common hemoglobin variants in an afro-descendent Ecuadorian population. BMC Res. Notes, 6.","DOI":"10.1186\/1756-0500-6-132"},{"key":"ref_10","first-page":"604892","article-title":"Gender Differences in the Pathogenesis and Outcome of Lupus and of Lupus Nephritis","volume":"2012","author":"Putterman","year":"2012","journal-title":"J. Immunol. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1186\/s13256-019-2242-1","article-title":"Myocarditis as a lupus challenge: Two case reports","volume":"13","author":"Khogali","year":"2019","journal-title":"J. Med. Case Rep."},{"key":"ref_12","first-page":"180","article-title":"Positive anti-Ro in lupus myocarditis: A case series report","volume":"30","year":"2023","journal-title":"Rev. Colomb. Reumatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"24","DOI":"10.3899\/jrheum.160493","article-title":"Lupus Myocarditis: Initial Presentation and Longterm Outcomes in a Multicentric Series of 29 Patients","volume":"44","author":"Thomas","year":"2017","journal-title":"J. Rheumatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e505","DOI":"10.7861\/clinmed.2021-0121","article-title":"Acute myocarditis: Aetiology, diagnosis and management","volume":"21","author":"Lampejo","year":"2021","journal-title":"Clin. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1001\/jama.2023.3371","article-title":"Diagnosis and Treatment of Acute Myocarditis: A Review","volume":"329","author":"Ammirati","year":"2023","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e011319","DOI":"10.1161\/CIRCIMAGING.120.011319","article-title":"Acute Myocarditis Complicating Systemic Lupus Erythematosus: Detection and Evolution of Transmural Spiral Late Gadolinium Enhancement on Cardiac Magnetic Resonance Imaging","volume":"14","author":"Kikuchi","year":"2021","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e000265","DOI":"10.1136\/lupus-2018-000265","article-title":"Myocarditis in systemic lupus erythematosus diagnosed by18 F-fluorodeoxyglucose positron emission tomography","volume":"5","author":"Bokhari","year":"2018","journal-title":"Lupus Sci. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1093\/rheumatology\/keac409","article-title":"Lupus myocarditis: Review of current diagnostic modalities and their application in clinical practice","volume":"62","author":"Karamchand","year":"2023","journal-title":"Rheumatology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3158","DOI":"10.1016\/j.jacc.2018.09.072","article-title":"Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation","volume":"72","author":"Ferreira","year":"2018","journal-title":"J. Am. Coll. Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/920\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:24:29Z","timestamp":1760027069000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/920"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,30]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030920"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030920","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,30]]}}}