# A Case of a 31-Year-Old Female Patient With Systemic Lupus Erythematosus Presenting With Lupus-Associated Pleural Effusions and Newly Diagnosed Lupus Nephritis

**Authors:** Khadyoth S Nanneboyina, Juan Avila

PMC · DOI: 10.7759/cureus.104625 · Cureus · 2026-03-03

## TL;DR

A 31-year-old woman with systemic lupus erythematosus developed lung and kidney complications, highlighting the disease's varied and complex nature.

## Contribution

The paper presents a clinical case illustrating the progression and management of pulmonary and renal manifestations in a patient with SLE.

## Key findings

- The patient presented with lupus-associated pleural effusions and newly diagnosed lupus nephritis.
- Management included adherence to current guidelines with hydroxychloroquine and other immunomodulators.
- The case emphasizes the importance of monitoring multiorgan involvement in SLE patients.

## Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multiorgan involvement and the presence of antinuclear antibodies (ANA). Given the potential for multiorgan involvement, patients with SLE can present with a variety of phenotypes. The most common presenting symptoms of SLE are constitutional, such as fevers, fatigue, malaise, and weight loss. This is followed in prevalence by cutaneous and musculoskeletal manifestations. Pulmonary, renal, and gastrointestinal manifestations occur at similar rates of prevalence. Workup of SLE involves checking autoantibodies and complement levels. Management of SLE is highly complex and varies based on disease severity as well as clinical presentation. Current guidelines recommend the use of hydroxychloroquine in all patients with SLE (unless contraindicated) along with other immunomodulators. In this article, we present the case of a 31-year-old woman with previously diagnosed SLE who presented with both pulmonary and renal manifestations. We discuss the disease progression, as well as an overview of the management for these manifestations.

## Linked entities

- **Chemicals:** hydroxychloroquine (PubChem CID 3652)
- **Diseases:** Systemic Lupus Erythematosus (MONDO:0007915), lupus nephritis (MONDO:0005556)

## Full-text entities

- **Genes:** SSB (small RNA binding exonuclease protection factor La) [NCBI Gene 6741] {aka LARP3, La, La/SSB, SSB/La}, TRIM21 (tripartite motif containing 21) [NCBI Gene 6737] {aka RNF81, RO52, Ro/SSA, SSA, SSA1, TRIM21/Ro52}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, C3 (complement C3) [NCBI Gene 718] {aka AHUS5, ARMD9, ASP, C3a, C3b, CPAMD1}, KRT20 (keratin 20) [NCBI Gene 54474] {aka CD20, CK-20, CK20, K20, KRT21}
- **Diseases:** enteritis (MESH:D004751), kidney injury (MESH:D007674), interstitial lung disease (MESH:D017563), serositis (MESH:D012700), palpitations (MESH:D006331), Pulmonary, renal, and gastrointestinal manifestations (MESH:C538458), malar rash (MESH:C000721270), infectious (MESH:D003141), pulmonary hypertension (MESH:D006976), sepsis (MESH:D018805), polyarthritis (MESH:D001168), lupus anticoagulant (MESH:C531622), neutropenia (MESH:D009503), lupus pleuritis (MESH:D010998), peritonitis (MESH:D010538), psychosis (MESH:D011618), gastrointestinal, and neuropsychiatric (MESH:D005767), weight loss (MESH:D015431), APL Ab (MESH:D016736), renal involvement (MESH:C565423), sclerosis (MESH:D012598), pleural effusion (MESH:D010996), verrucous rash (MESH:D005076), hypoxic (MESH:D002534), urticaria (MESH:D014581), alveolar hemorrhage (MESH:D006470), autoimmune disease (MESH:D001327), myositis (MESH:D009220), chest pain (MESH:D002637), fatigue (MESH:D005221), lupus pneumonitis (MESH:D011014), stroke (MESH:D020521), acute kidney injury (MESH:D058186), proteinuria (MESH:D011507), fever (MESH:D005334), pulmonary emboli (MESH:D020766), Lupus (MESH:D008180), pericardial effusion (MESH:D010490), inflammatory (MESH:D007249), headaches (MESH:D006261), hematuria (MESH:D006417), pain (MESH:D010146), nephrotic (MESH:D009404), hepatosplenomegaly (MESH:C535727), dyspnea (MESH:D004417), kidney failure (MESH:D051437), Lupus Nephritis (MESH:D008181), shoulder pain (MESH:D020069), shrinking lung syndrome (MESH:D008171), avascular necrosis (MESH:D010020), discoid lupus rash (MESH:D008179)
- **Chemicals:** steroids (MESH:D013256), prednisone (MESH:D011241), TMP-SMX (MESH:D015662), anifrolumab (MESH:C582345), warfarin (MESH:D014859), creatinine (MESH:D003404), hydroxychloroquine (MESH:D006886), rituximab (MESH:D000069283), piperacillin-tazobactam (MESH:D000077725), ceftriaxone (MESH:D002443), apixaban (MESH:C522181), methotrexate (MESH:D008727), methylprednisolone (MESH:D008775), cyclophosphamide (MESH:D003520), enoxaparin (MESH:D017984), MMF (MESH:D009173), belimumab (MESH:C511911), azithromycin (MESH:D017963), oxygen (MESH:D010100), azathioprine (MESH:D001379)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12956268/full.md

## References

9 references — full list in the complete paper: https://tomesphere.com/paper/PMC12956268/full.md

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Source: https://tomesphere.com/paper/PMC12956268