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Case Report A -year-old college student at a local university with a history of SLE diagnosed in 00 (ANA+, anti-dsDNA+, and anti-SSA+) presented to an outside hospital complaining of shortness of breath, fever, and pleuritic chest pain. These symptoms began acutely in the presence of a week-old lupus flare characterized by a butterfly malar rash and arthralgias. A chest CT demonstrated a small pericardial effusion without evidence of tamponade. She was diagnosed with pericarditis and subsequently her outpatient dose of prednisone was increased from 15 mg/day to 60 mg/day. However, she showed little clinical or radiographic improvement on CT. She was then scheduled to receive pulse dose steroids (methylprednisolone) for days.

A 22-year-old woman with systemic lupus erythematosus develops cardiac tamponade