Posters
Presenting Author Academic/Professional Position
Alhasan Asaad
Academic Level (Author 1)
Resident
Discipline/Specialty (Author 1)
Internal Medicine
Academic Level (Author 2)
Resident
Discipline/Specialty (Author 2)
Internal Medicine
Academic Level (Author 3)
Resident
Discipline/Specialty (Author 3)
Internal Medicine
Academic Level (Author 4)
Faculty
Discipline/Specialty (Author 4)
Internal Medicine
Discipline Track
Clinical Science
Abstract Type
Case Report
Abstract
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by multisystem involvement and a highly variable clinical presentation. It predominantly affects women of childbearing age and arises from complex interactions between genetic, environmental, and hormonal factors, resulting in immune dysregulation and widespread inflammation. The disease can manifest in nearly any organ system, with common presentations including skin rashes, arthritis, renal dysfunction, and hematologic abnormalities. Despite advances in understanding its pathogenesis and management, SLE remains a diagnostic and therapeutic challenge due to its heterogeneous nature and potential for severe complications. This case report highlights a unique presentation of SLE, emphasizing its diagnostic complexity and the importance of a multidisciplinary approach to care.
Case Presentation: A 60-year-old Hispanic female with past medical history of type II diabetes mellitus, dyslipidemia, and autoimmune hemolytic anemia (AIHA) presented to the emergency department (ED) in December 2024 with shortness of breath and pleuritic chest pain. She was diagnosed with AIHA at another institution in October 2024 and completed treatment with Rituximab in November 2024. On admission, imaging revealed moderate bilateral pleural effusions and a small pericardial effusion. Comprehensive work-up was negative for lung parenchymal disease/infection, pulmonary embolism, myocardial ischemia/infarction and deep venous thrombosis. On physical examination upon initial contact with our team, the patient was noted to have a faint malar “butterfly” rash over the face. Diagnostic testing confirmed a diagnosis of Systemic Lupus Erythematosus (SLE) using all three approved diagnostic criteria (ACR, SLICC and EULAR). Patient improved after initiation of steroids and was referred to a rheumatologist for specialized follow up and appropriate management.
Conclusion: This case highlights the complicated nature of SLE when it comes to evaluation and diagnosis, particularly when it comes to the physical examination. While the same can be said about several other autoimmune conditions, SLE is particularly challenging due to its multisystemic involvement, widely variable initial presentations, and lack of specialty services in many hospitals in the United States. Early diagnosis and treatment can make a huge impact on the clinical course of patients with SLE.
Presentation Type
Poster
Recommended Citation
Asaad, Alhasan; Duran, Dixie; Duran-Nesovic, Cristina; and Campo Maldonado, Jose E., "Anemia Is Never the Diagnosis: Autoimmune Hemolytic Anemia as a Herald of Late-Onset Systemic Lupus Erythematosus" (2025). Research Colloquium. 4.
https://scholarworks.utrgv.edu/colloquium/2025/posters/4
Included in
Anemia Is Never the Diagnosis: Autoimmune Hemolytic Anemia as a Herald of Late-Onset Systemic Lupus Erythematosus
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by multisystem involvement and a highly variable clinical presentation. It predominantly affects women of childbearing age and arises from complex interactions between genetic, environmental, and hormonal factors, resulting in immune dysregulation and widespread inflammation. The disease can manifest in nearly any organ system, with common presentations including skin rashes, arthritis, renal dysfunction, and hematologic abnormalities. Despite advances in understanding its pathogenesis and management, SLE remains a diagnostic and therapeutic challenge due to its heterogeneous nature and potential for severe complications. This case report highlights a unique presentation of SLE, emphasizing its diagnostic complexity and the importance of a multidisciplinary approach to care.
Case Presentation: A 60-year-old Hispanic female with past medical history of type II diabetes mellitus, dyslipidemia, and autoimmune hemolytic anemia (AIHA) presented to the emergency department (ED) in December 2024 with shortness of breath and pleuritic chest pain. She was diagnosed with AIHA at another institution in October 2024 and completed treatment with Rituximab in November 2024. On admission, imaging revealed moderate bilateral pleural effusions and a small pericardial effusion. Comprehensive work-up was negative for lung parenchymal disease/infection, pulmonary embolism, myocardial ischemia/infarction and deep venous thrombosis. On physical examination upon initial contact with our team, the patient was noted to have a faint malar “butterfly” rash over the face. Diagnostic testing confirmed a diagnosis of Systemic Lupus Erythematosus (SLE) using all three approved diagnostic criteria (ACR, SLICC and EULAR). Patient improved after initiation of steroids and was referred to a rheumatologist for specialized follow up and appropriate management.
Conclusion: This case highlights the complicated nature of SLE when it comes to evaluation and diagnosis, particularly when it comes to the physical examination. While the same can be said about several other autoimmune conditions, SLE is particularly challenging due to its multisystemic involvement, widely variable initial presentations, and lack of specialty services in many hospitals in the United States. Early diagnosis and treatment can make a huge impact on the clinical course of patients with SLE.
