{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:56:13Z","timestamp":1792688173605,"version":"4.5.0"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:00:00Z","timestamp":1702425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Elevated CA-125 levels, polyserous effusions (such as pleural effusion, ascites, etc.) in young women with systemic lupus erythematosus (SLE) may signal pseudo-pseudo Meigs\u2019 syndrome (PPMS), after excluding other causes. We describe a 32-year-old SLE patient with recurrent bilateral pleural effusions and unexplained hypercalcemia for 10 months. Extensive evaluations revealed no infections or tumors. Cytokine analysis showed elevated interleukin (IL) levels, especially IL-6 in pleural effusion. Treatment with immunosuppressive therapy resulted in reduced cancer antigen (CA) 125 levels and decreased effusion volume, demonstrating a positive response to intervention in this case of PPMS.<\/jats:p>","DOI":"10.3389\/fimmu.2023.1277683","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T04:25:42Z","timestamp":1702441542000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Deciphering the puzzle: a case report of Tjalma syndrome (pseudo-pseudo Meigs' syndrome) with profoundly elevated CA-125 and pleural effusion"],"prefix":"10.3389","volume":"14","author":[{"given":"Qing","family":"Tan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li Feng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng Hui","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen Hui","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shui Lian","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2004.12.022","article-title":"Ascites, pleural effusion, and CA 125 elevation in an SLE patient, either a Tjalma syndrome or, due to the migrated Filshie clips, a pseudo-Meigs syndrome","volume":"97","author":"Tjalma","year":"2005","journal-title":"Gynecol Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1097\/LBR.0b013e31827ccb35","article-title":"Ovarian mass, pleural effusion, and ascites: revisiting Meigs syndrome","volume":"20","author":"Riker","year":"2013","journal-title":"J Bronchol Interv Pulmonol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1272\/jnms.JNMS.2020_87-205","article-title":"Pseudo-meigs syndrome caused by a giant uterine leiomyoma with cystic degeneration: A case report","volume":"87","author":"Yaguchi","year":"2020","journal-title":"J Nippon Med Sch Nippon Ika Daigaku Zasshi"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e15393","DOI":"10.1097\/MD.0000000000015393","article-title":"Pseudo-pseudo Meigs\u2019 syndrome presenting with a combination of polyserositis, elevated serum CA 125 in systemic lupus erythematosus: A case report","volume":"98","author":"Gao","year":"2019","journal-title":"Med (Baltimore)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.reumae.2018.09.003","article-title":"Tjalma syndrome (Pseudo-pseudo meigs\u2019) as initial manifestation of juvenile-onset systemic lupus erythematosus","volume":"15","author":"Torres Jim\u00e9nez","year":"2019","journal-title":"Reumatol Cl\u00ednica Engl Ed"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2004.11.003","article-title":"Therapeutic options for refractory massive pleural effusion in systemic lupus erythematosus: a case study and review of the literature","volume":"34","author":"Breuer","year":"2005","journal-title":"Semin Arthritis Rheum"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.23937\/2377-9004\/1410187","article-title":"A pelvic mass masquerading as high stage Malignancy - 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