Cardiac tamponade revealing primary antiphospholipid syndrome. Two case-reports.

Two patients developed cardiac tamponade as the inaugural manifestation of primary antiphospholipid syndrome. One was a 29-year-old man who required emergency pericardiocentesis after confirmation of the clinical diagnosis by echocardiography. He then developed a transient ischemic attack. The test for antiphospholipid antibody was positive on two occasions (IgG, 91.41 G phopholipid units, GPL). Systemic lupus erythematous (SLE) was ruled out. The outcome was favorable within three months under corticosteroid and antiplatelet therapy. The second patient was a 44-year-old woman who also required emergency pericardiocentesis for cardiac tamponade. She had a history of recurrent fetal loss and venous thrombosis. The test for antiphospholipid antibody was positive (104.21 GPL units). There was no evidence of SLE. The outcome was favorable within four months under corticosteroid therapy. Patients with unexplained cardiac tamponade should be investigated for antiphospholipid antibody syndrome.