Unusual Case Presentation of Systemic Lupus Erythematosus in a Young Woman

Systemic Lupus Erythematosus (SLE) is a chronic multisystem autoimmune disease. Serositis occurs in 16% of SLE patients, and while cardiac tamponade acute peritonitis with ascites can occur during the course disease, they are rare as first presentation. A 25-year-old woman presented to emergency department Tishreen Hospital complaints dyspnea, fever, chills, chest abdominal pain. Two months prior, she suffered from musculoskeletal pain, fatigue, anorexia, weight loss about 15 kg, severe hair loss, recurrent oral aphthous. On clinical examination, patient was pale tired dyspnea pitting edema (grade 3–4). Pericardiocentesis emergently performed because there were signs tamponade. Three days later, developed an surgical abdomen due ascites. Later, diagnosed after excluding malignant infectious diseases. Consequently, methylprednisolone pulses, azathioprine, hydroxychloroquine 200 mg/day introduced immediately. The status dramatically improved, three symptom-free normal laboratory tests. In conclusion, although initial presentation very rare, coincidently.