{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:03:33Z","timestamp":1761807813364},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Res Notes"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Abrupt and life-threatening presentations in connective tissue diseases (CTD) are rarely reported. Their early recognition and specific management could change course disease. SLE is a multisystem inflammatory disease that is often difficult to diagnose in the emergency department (ED).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>A 26-year-old woman presented to the ED with a 48\u00a0hour history of progressive dispnea, generalized edema and left lower chest pain with non-productive cough. On examination, patient was feeling very ill, afebrile, tachycardic, tachypneic and a peripheral oxygen saturation of 94% on 40% supplemented oxygen with raised jugular venous pressure was noted. Intermittently, she presented an obtunded state of consciousness. A large pericardial, pleural and abdominal effusion was confirmed and a broad differential diagnosis was made. The patient had a 6\u00a0months history of inflammatory polyarthralgias involving initially interphalangeal joints, evolving, sometime later, the knees and elbows bilaterally and she was started glucocorticoids. 12\u00a0days before admission, she had had symptoms of a urethritis episode. In the context of an immunosupressed patient, with initial focal urologic complains, evidence of multiorgan dysfunction and a picture resembling a distributive shock, dictated a low threshold for sepsis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Separating an acute episode of SLE from sepsis, on emergency grounds, can even be the most challenging decision. In the ED, acute life-threatening and multisystemic conditions should arise the suspicion of autoimmune diseases, particularly SLE.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1756-0500-6-181","type":"journal-article","created":{"date-parts":[[2013,5,5]],"date-time":"2013-05-05T10:14:03Z","timestamp":1367748843000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Presentation of systemic lupus erythematosus (SLE) in emergency department: a case report"],"prefix":"10.1186","volume":"6","author":[{"given":"Nat\u00e1lia","family":"Fernandes","sequence":"first","affiliation":[]},{"given":"Guilherme","family":"Gomes","sequence":"additional","affiliation":[]},{"given":"Carlos","family":"Capela","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2013,5,5]]},"reference":[{"issue":"7","key":"2215_CR1","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1177\/0961203308100659","volume":"18","author":"E Rosenbaum","year":"2009","unstructured":"Rosenbaum E, Krebs E, Cohen M, Tiliakos A, Derk CT: The spectrum of clinical manifestations, outcome and treatment of pericardial tamponade in patients with systemic lupus erythematosus: a retrospective study and literature review. 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