Pseudo–pseudo Meigs' syndrome (PPMS) in chronic lupus peritonitis: a case report with review of literature

Abstract

Gastrointestinal involvement in systemic lupus erythematosus (SLE) usually occurs in the form of mesenteric vasculitis, protein-losing enteropathy, intestinal pseudo-obstruction, and pancreatitis. We describe a 23-year-old female, a known case of SLE presented with significant ascites and pleural effusion. Further evaluation showed elevated CA-125 levels without evidence of malignancy. The patient was treated with corticosteroids, hydroxychloroquine, and azathioprine resulting in the resolution of ascites in 2 weeks. The triad of ascites, pleural effusion, and increased CA-125 is known as pseudo-pseudo Meigs' syndrome, which is rarely reported in the literature. Clinicians should be aware of this entity while evaluating an SLE patient with low serum-ascites albumin gradient (SAAG) ascites.

Keywords:

• Systemic lupus erythematosus
• lupus peritonitis
• pseudo-pseudo Meigs' syndrome
• PPMS

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The patient gave their informed written consent prior to their inclusion in this case report.

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Conflicts of interest

None.

Additional information

Funding

This manuscript has been prepared without third-party contribution nor financial support.