Introduction:Pericardial syndromes are not uncommon manifestations in clinical practice [1]. About 5% of all patients admitted to the emergency department with the chief complaint of chest pain, are diagnosed with acute pericarditis [2]. Cardiac involvement is a common presentation of different autoimmune rheumatic diseases. Systemic lupus erythematous (SLE) is a chronic autoimmune rheumatic disease with multiorgan involvement. Cardiac involvement has been reported in about 50% of SLE patients; in some cases, as their first presentation of SLE [3]. The most common type of cardiac involvement in SLE patients is pericarditis [4]. While it is classically known that SLE like most of other autoimmune diseases are more prevalent in women, cardiac involvement as pericarditis in SLE is more prevalent in male patients [2]. Although being a common manifestation of SLE, it is uncommon for acute fibrinous pericarditis with constrictive features to be the first presentation of SLE in patients with severe manifestations and in need for hospital admission [5].