Post-cardiac Injury Syndrome in a Systemic Lupus Erythematosus Patient After an Open-Heart Operation: A Case Report.

Post-cardiac injury syndrome (PCIS) is an inflammatory condition caused by a cardiac injury that can affect the pericardium, pleura, or both. We describe a female patient who underwent heart surgery and thereafter developed pericardium and pleural effusion. She was also known to have systemic lupus erythematosus (SLE). Due to the possibility that each of these symptoms could impact the pericardium or pleura, we came to the conclusion that they could be caused by either PCIS, SLE, or both. A 54-year-old woman underwent open heart surgery three weeks ago and required aortic valve replacement and coronary artery bypass grafting (CABG). She presented to the emergency room complaining of fatigue, chest pain, shortness of breath, coughing, and fever for five days. She had a history of SLE for seven years. The patient was found to have a right-side pleural effusion, a pericardial effusion, and a high inflammatory marker based on imaging and laboratory evaluations. A right pleural-side image-guided percutaneous pigtail catheter drainage was inserted. Exudative fluid appeared in the pleural fluid analysis, and a mild pericardial effusion was seen on echocardiography. The patient was diagnosed with pericarditis and treated with prednisone, colchicine, and antibiotics. Six days later, she was discharged in good general condition. In this particular case of SLE with a chronic inflammatory reaction, PCIS developed following valve replacement surgery. The activation and destruction of endothelial cells are frequently seen in both SLE and PCIS, leading us to believe that there may be a possible reciprocal interaction between these two distinct autoimmune illnesses.

Anaplastic Large Cell Lymphoma Misdiagnosed as Systemic Lupus Erythematosus: A Report of a Rare Case.

Non-Hodgkin lymphomas are a diverse group of lymphoproliferative disorders rising from the lymphocytes with a broad spectrum of histological characteristics and clinical manifestations that often complicate accurate diagnosis. Autoantibodies have been observed at higher frequencies in lymphoproliferative diseases, yet the precise role of the immune system and the underlying causative factors remain enigmatic. Anaplastic large cell lymphoma (ALCL), an aggressive non-Hodgkin's lymphoma variant, commonly presents in a manner akin to other aggressive lymphomas, featuring swift progression of peripheral and/or retroperitoneal adenopathy, accompanied by systemic symptoms like fever, night sweats, and weight loss. This case report delves into a histologically verified instance of ALCL, which strikingly emulates systemic lupus erythematosus. This report's objective is to underscore the concept that lymphoma can manifest clinical or biological features reminiscent of autoimmunity.

Diffuse Alveolar Hemorrhage in an Undiagnosed Systemic Lupus Erythematosus Patient.

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease characterized by a wide range of clinical manifestations affecting multiple organs. While standardized diagnostic criteria are commonly used, the lack of pathognomonic presenting signs and symptoms often makes the diagnosis challenging. Of the many pulmonary manifestations, diffuse alveolar hemorrhage (DAH) is one of the most severe complications caused by the disruption of the capillary alveolar interface. Although this condition is rarely encountered, it has a rapidly progressive course and can be life-threatening, which warrants a prompt diagnostic workup and an aggressive therapeutic approach. We report a case of a 58-year-old female who presented to the emergency department with dyspnea and multiple episodes of hemoptysis. Further investigations revealed anemia, thrombocytopenia, and diffuse bilateral infiltrates on high-resolution computed tomography, consistent with DAH in a patient with undiagnosed SLE.