• Yi-Hsiang Chao and Hsin-Yu Chen.
• Department of Surgery, Kaohsiung Veteran General Hospital, No. 386, Dazhong 1st Road, Zuoying District, Kaohsiung City 813, Kaohsiung, Taiwan. Electronic address: hsiang@vghks.gov.tw.
• J Formos Med Assoc. 2022 Dec 1; 121 (12): 263326382633-2638.

AbstractPseudo-pseudo Meigs' syndrome (PPMS) exhibits patients with ascites, pleural effusion, elevated CA-125, and diagnosed of systemic lupus erythematosus (SLE) eventually without evidence of ovarian or pelvic tumor. It's a rare diagnosis but it has a good response to treatment. We here present an 82-year-old female, who was found to have ascites, pleural effusion, and elevated CA-125. CT of abdomen revealed absence of pelvic tumor. However, a rapid decline in renal function and progressive proteinuria were also observed. We performed an autoimmune-associated investigation. A diagnosis of late-onset SLE was made due to meeting the criteria of serositis, hemolytic anemia, thrombocytopenia, renal disease, and positive anti-smith antibody. We gave this patient a regimen with steroids and hydroxychloroquine. Both ascites and pleural effusion resolved in one month. PPMS is an important differential diagnosis in female patients with ascites, pleural effusion, and elevated CA-125. A survey of the pelvic tumor should be done first to exclude Meigs' syndrome or pseudo-Meigs' syndrome. SLE flare-up should be kept in mind even in the elderly.Copyright © 2022 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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