Recurrent Cardiac Tamponade Due to Minoxidil Associated Drug Induced Lupus Erythematosus

A 59-year-old man with a history of various health conditions presented with symptoms of cardiac tamponade (CT), a serious condition where fluid builds up around the heart. After two episodes of CT and subsequent treatments, it was discovered that he had been treated for hypertension with minoxidil, among other drugs, for the past 5 years. Minoxidil, a potent peripheral arterial vasodilator, is approved for androgenetic alopecia (hair loss) and refractory hypertension. However, it can cause side effects such as fluid retention, which can lead to pericardial effusion (fluid around the heart), a condition reported in approximately 3-5% of patients receiving minoxidil therapy. The patient's positive anti-histone antibody and biopsy-proven serositis suggested minoxidil also carries a risk of drug-induced lupus erythematosus (DILE). The study highlights the need for clinicians to be aware of this rare but serious complication associated with minoxidil due to its widespread use.