Chylous ascites and chylothorax as presentation of a systemic progression of discoid lupus.
We describe a patient with a history of discoid lupus erythematosus who presented with chylous ascites and chylothorax. Analysis of peritoneal and pleural fluid showed a high level of triglycerides and the presence of antinuclear antibody and anti-dsDNA antibody. Further study revealed other diagnostic criteria for systemic lupus erythematosus and serologic markers of disease activity. The patient was successfully treated with methylprednisolone pulse therapy and high doses of prednisone, followed by immunosuppressants.
Department of Medicine, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina. dmanzella@fmed.uba.ar
Diego Jorge
DJ
Manzella
Pablo Nicolás
PN
Dettori
Mariano Luis
ML
Hertimian
Marcelo José
MJ
Melero
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D002916:Chylothorax / Q000175:diagnosis* / Q000188:drug therapy; D002915:Chylous Ascites / Q000175:diagnosis* / Q000188:drug therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008179:Lupus Erythematosus, Discoid / Q000175:diagnosis* / Q000188:drug therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D019152:Paracentesis; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D006886:Hydroxychloroquine; D008775:Methylprednisolone