A challenging diagnosis in a male presented with ascites: Pseudo-pseudo Meigs syndrome and systemic lupus erythematosus/Asit ile basvuran erkek hastada tanisal zorluk: Psodo-psodo Meigs sendromu ve sistemik lupus eritematoz

• Published in: Journal of Turkish Society for Rheumatology 2024-07, Vol.16 (2), p.77
• Main Authors: Yildirim, Resit, Oruc, Huseyin, Dinler, Mustafa, Cansu, Dondu Uskudar, Korkmaz, Cengiz
• Format: Article
• Language: English
• Subjects: Ascites; Diagnosis; Kidney diseases; Lupus; Systemic lupus erythematosus
• ISSN: 2651-2653
• DOI: 10.4274/raed.galenos.2024.19480

Gastrointestinal involvement as an initial presentation of systemic lupus erythematosus (SLE) is seen uncommonly. Among such presentations, ascites is an extremely rare clinical condition that requires extensive diagnostic investigation for nephrotic syndrome, tuberculosis, congestive heart failure, constructive pericarditis, and malignancy besides of SLE-related conditions such as lupus peritonitis, protein losing enteropathy, and pseudo-pseudo Meigs syndrome (PPMS). PPMS is still a debatable clinical description, characterized by ascites, elevated CA-125 levels, and absence of malignancy in an SLE patient. Notably, the clinician should keep in mind that all these possibilities could be the anchor manifestation of SLE as well. Therefore, definitive diagnosis might be challenging in case of ascites in an SLE patient. Herein, we aimed to share the difficulties from the first presentation to the definitive diagnosis in a patient with PPMS in the light of similar cases in the literature. Keywords: Systemic lupus erythematosus, male, ascites, pseudo-pseudo Meigs syndrome Gastrointestinal sistem tutulumu, sistemik lupus eritematozus (SLE) hastalarinda nadir olarak baslangic bulgusu olabilir. Asitle basvuran bir SLE hastasinda; SLE ile iliskili olan lupus peritoniti, protein kaybettiren enteropati ve pseudo-pseudo Meigs sendromu (PPMS) gibi tanilarin yanisira, nefrotik sendrom, tuberkuloz, kalp yetmezligi, konstriktif perikardit ve malignite gibi SLE disi klinik durumlar da ayirici taniya girmesi nedeniyle detayli bir inceleme gereklidir. PPMS, SLE hastasinda asit, yuksek CA-125 seviyeleri ve malignite dislandiktan sonra tani konan tartismali bir klinik durumdur. SLE'nin bu klinik tablolardan biriyle ortaya cikabilecegi unutulmamalidir. Bu nedenle, SLE hastasinda asit durumunda kesin tani koymak zor olabilir. Bu yazida, literatur verileri isiginda PPMS tanisinin ilk belirtiden kesin taniya kadar olan surecte yasanan zorluklari paylasmayi amacladik. Anahtar Kelimeler: Sistemik lupus eritematoz, asit, erkek, psodopsodo Meigs sendromu