skip to main content

SLE Serositis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRheumatologySLE SerositisRACP Adult Medicine

A 45-year-old woman with SLE develops acute pleuritic chest pain. She has positive antiphospholipid antibodies but no prior thrombotic events. Her D-dimer is elevated but CTPA shows no pulmonary embolism. She has bilateral small pleural effusions and pericardial effusion. What is the most likely cause of her chest pain?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — SLE serositis

In SLE, serositis (pleuritis and/or pericarditis) is a common manifestation of active disease. The bilateral pleural effusions and pericardial effusion in the context of active SLE (with an elevated D-dimer that can be falsely elevated in lupus flare) is most consistent with lupus serositis. Treatment includes NSAIDs for mild symptoms and corticosteroids for moderate-severe serositis. The negative CTPA excludes PE. Complement levels and anti-dsDNA should be checked to assess disease activity.

Reference: eTG – 2025 – Rheumatology; EULAR – 2023 – SLE Management Recommendations