Our patient’s treatment regimen with NSAIDs changed to disease-modifying anti-rheumatic drugs (DMARDs) administration of hydroxychloroquine with a daily dose of 400mg.

Our patient was discharged home after 2 weeks of admission with the diagnosis of acute fibrinous pericarditis as the first manifestation of SLE. He had weekly follow-up visits with TTE examinations.

On his sixth week of anti-inflammatory treatment at his follow-up visit, all of his signs and symptoms were resolved. TTE study showed that all the pericardial fibrin strands and effusion were completely resolved (Figure 6 (A) and (B)) (Supplementary video 3). Hemodynamic of constrictive pattern was completely reversed in doppler study of mitral valve inflow with no respiratory variations.