Abstract
A case of elderly-onset systemic lupus erythematosus presenting with bilateral pleural effusions associated with atypical lupus erythematosus cell is reported. An 81-year old man was admitted to our hospital for evaluation and treatment of bilateral pleural effusions. On admission, thrombocytopenia and proteinuria were noted. Although the pleural fluid was exudative, cytologic examination, bacterial culture and acid-fast stain were all negative. Several autoantibodies such as antinuclear antibody, antideoxyribonucleic acid (DNA) antibody, anti-double stranded anti-DNA antibody, platelet-associated IgG were positive, and serum levels of complements and immune complexes were low and high, respectively. In addition, antinuclear antibody, anti-DNA antibody and immune complexes were detected in the pleural fluid. The Papanicolaou smear of the pleural fluid showed scattered cells resembling to LE cells. Based on these results, a diagnosis of lupus pleuritis was made and prednisolone 30 mg/day was administered. The pleural effusions disappeared in about 2 weeks
