A 24-year-old woman with bilateral pulmonary infiltrates, pericardial effusion, and bilateral pleural effusions.

A 24-year-old woman presented with a 3-week history of exertional dyspnea and dry cough. Her medical history was remarkable for rheumatoid arthritis (RA). She had no exacerbation of joint symptoms during the prior 2 years. She denied fever or other constitutional symptoms. She took ibuprofen occasionally but no other antirheumatic medications. She was a lifelong nonsmoker. Her review of systems, family, social, and exposure histories were noncontributory.