Acute systemic lupus erythematosus on the acute medical take: are we missing anything?

摘要

A 42-year-old man with a background of systemic lupus erythematosus (SLE) presented acutely to the medical admissions unit (MAU) with pleuritic chest pain, shortness of breath and arthralgia. He was receiving no regular medications and denied any other medical problems, any cough, recent flights, calf pain or immobility. He described the chest pain as sudden onset, right sided and exacerbated by deep inspiration. He rated the pain as 10/10 severity and required opiate analgesia on admission to the MAU. On clinical examination the pain was increased by palpation at the right inferior anterior costal margin. The remainder of systems examinations were unremarkable with no rash, no syn-ovitis and no audible pleural or pericardial rub.