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  • Title: Diagnosis of systemic lupus erythematosus with early manifestation of an eosinophilic pleural effusion.
    Author: Cho G, Matti M, Ghassemzadeh S, Nobari M.
    Journal: BMJ Case Rep; 2022 Nov 04; 15(11):. PubMed ID: 36332931.
    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.
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