# Systemic Lupus Erythematosus and Lupus Nephritis Presenting as Severe Constitutional Symptoms

## TL;DR

A 48-year-old woman with severe symptoms was diagnosed with lupus and kidney inflammation after a thorough evaluation.

## Contribution

The case highlights the importance of considering rheumatologic conditions in patients with nonspecific symptoms.

## Key findings

- The patient was diagnosed with SLE and lupus nephritis despite initial suspicion of malignancy or infection.
- Early rheumatologic consultation and testing led to a timely diagnosis.
- The case was complicated by pericardial effusion and MRSA infection.

## Abstract

Systemic lupus erythematosus (SLE) is a remitting-relapsing systemic autoantibody and immune complex disease with a similar clinical presentation to that of malignancy and infection. The authors report a case of newly diagnosed SLE and lupus nephritis in a 48-year-old woman with constitutional symptoms and unintentional weight loss. Her presentation was further complicated by pericardial effusion and methicillin-resistant Staphylococcus aureus (MRSA) facial cellulitis and bacteremia. In the context of nonspecific symptoms and a wide initial differential diagnosis, the early consideration of rheumatologic etiologies and the involvement of consultant services led to appropriate diagnostic testing and a timely diagnosis.