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Diagnosis of systemic lupus erythematosus with early manifestation of an eosinophilic pleural effusion
  1. Gene Cho1,
  2. Moreen Matti1,
  3. Saeed Ghassemzadeh1,2 and
  4. Matthew Nobari1,3
  1. 1Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California San Diego, La Jolla, California, USA
  2. 2School of Medicine, University of California San Diego, La Jolla, California, USA
  3. 3Pulmonary and Critical Care Medicine, Loyola University Medical Center, Maywood, IL, USA
  1. Correspondence to Dr Matthew Nobari; Matthew.Nobari{at}lumc.edu

Abstract

A woman in her 70s with a history of Crohn’s disease presented to the emergency department with dyspnoea, cough and intermittent fevers. Evaluation revealed a pleural effusion with neutrophil predominance, and initial suspicion of infection prompted a short course of antibiotic therapy. However, the patient subsequently developed recurrent pleural effusion with eosinophilic predominance. Serological data confirmed a diagnosis of systemic lupus erythematosus (SLE) and the patient was started on appropriate treatment.

This case presents an initial manifestation of eosinophilic-dominant pleural effusion in SLE. Current guidelines in treating pleural effusions do not explore rheumatological causes. However, we believe that our case demonstrates the value of a prompt investigation for rheumatological aetiologies in an otherwise unclassified eosinophilic-predominant pleural effusion. Such an investigation should include serological data as an important confirmatory marker for the diagnosis of SLE.

  • Immunology
  • Pathology
  • Respiratory medicine

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Footnotes

  • Contributors MN was the physician involved in treatment of the patient and initiated the project, as well as gathering relevant data. MN is the guarantor. GC, MM and SG drafted the paper, along with the necessary literature research. All authors were involved in revisions, with MN serving as the case advisor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.