Although tuberculosis (TB) remains a prevalent cause of constrictive pericarditis that presents with pleural effusion in high-endemic countries like India, other causes of serositis should also be considered. Serositis—like pericarditis, pleuritis, and peritonitis—is the most predominant clinical manifestation of systemic lupus erythematosus (SLE), an autoimmune disorder. Serositis accounts for an incidence of 11–54% in SLE. Pericardial effusion and cardiac tamponade are the rare initial manifestations of SLE. Effusive–constrictive pericarditis (ECP) and bilateral pleural effusion with no articular and cutaneous involvement are rare. Effusive–constrictive pericarditis is a rare syndrome that causes constriction of the visceral pericardium and effusion that produces a tamponade-like effect on the heart. Medical management includes treating the underlying cause of inflammation with steroids and non-steroid anti-inflammatory drugs, followed by diuretics to relieve the volume overload symptoms. The only effective treatment for ECP is pericardiectomy, which involves removing both the parietal and visceral pericardium.
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