{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:41Z","timestamp":1756425821178,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,11,17]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:p>Segmental involvement of medium-sized vessels are lesser-known manifestations of systemic lupus erythematosus (SLE) vasculopathy. Medium vessel vasculopathy and peripheral vascular disease (PVD) mimicking manifestations of SLE, although rare, have been reported, particularly in Asian women mostly under the age of 30 years. This is due to metabolic disadvantages in their ethnicity, with high incidence of insulin resistance and resulting metabolic syndrome, leading to lower high-density lipoprotein cholesterol levels, higher triglyceride levels and small dense low-density lipoprotein, increased proinflammatory cytokines, endothelial dysfunction and procoagulant tendency. Owing to the longer duration of the disease with the simultaneous use of steroids, vessels are often affected. SLE may also present with thyroid manifestations against a background of a proinflammatory immune state, where autoimmune thyroid diseases, such as Hashimoto\u2019s thyroiditis, may coexist. Here, we describe the case of a young woman who presented with progressive shortness of breath, right leg pain and cough with amenorrhoea and was diagnosed with SLE.<\/jats:p>","DOI":"10.1136\/bcr-2022-251953","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T10:35:37Z","timestamp":1669718137000},"page":"e251953","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic lupus erythematosus presenting as right-sided massive pleural effusion with autoimmune hypothyroidism and medium vessel vasculopathy"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5634-5265","authenticated-orcid":false,"given":"Baijaeek","family":"Sain","sequence":"first","affiliation":[{"name":"Department of Trauma & Orthopaedics, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Department of General and Upper GI Surgery, Aneurin Bevan University Health Board, Newport, Wales, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ritam","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Department of Critical Care, AMRI Hospitals, Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, KPC Medical College and Hospital, Jadavpur, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arpit","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Critical Care, AMRI Hospitals, Kolkata, West Bengal, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"key":"2025082802253312000_15.11.e251953.1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.7326\/0003-4819-49-1-70","article-title":"Pleuritis in systemic lupus erythematosus: 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