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SLE serositis — SCE Rheumatology MCQ

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ModerateConnective tissue diseasesSLE serositisSCE Rheumatology

A 34-year-old woman with SLE on hydroxychloroquine presents with pleuritic chest pain and arthralgia. Temperature is 37.1°C, C3 is low, anti-dsDNA is high and CRP is 8 mg/L; urine dip is negative and CT pulmonary angiogram excludes embolism. What is the most likely diagnosis?

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Correct answer: E — SLE serositis flare

Low complement and rising anti-dsDNA with modest CRP support lupus flare with serositis after pulmonary embolism has been excluded. Markedly raised CRP or focal consolidation would push towards infection, which remains an important mimic. Hydroxychloroquine should usually be continued unless contraindicated.

Reference: BSR SLE guideline; EULAR SLE recommendations