Chylothorax as a rare manifestation of systemic lupus erythematosus flare up - case study


SLE, Chylothorax, rare complication

How to Cite

Jeraiby, M., Nabil, M., Juahar, I., & Mohammed, J. (2022). Chylothorax as a rare manifestation of systemic lupus erythematosus flare up - case study. Rheumatology (Bulgaria), 30(1), 90-94.


We present a case of systemic lupus erythematosus (SLE), which was diagnosed before 7 years, and antirheumatic therapy was prescribed. However, following relief of the initial symptoms, the patient stopped taking medications and presented again, after being symptom-free for three years, with chylothorax and symptoms, which were entirely different from the first visit. The patient was treated with a combination of hydroxychloroquine, prednisolone and azathioprine following ruling out of malignancy and infections and responded well to the therapy.


  1. StrausserJL, Flye MW. Management of nontraumatic chylothorax. Ann Thorac Surg,1981,31, 520-526.
  2. Lee CK, Han JM, Lee KN, et al. Concurrent occurrence of chylothorax, chylous ascites, and protein-losing enteropathy in systemic lupus erythematosus. J Rheumatol. 2002;29:1330Y1333.
  3. Lin YJ, Chen DY, Lan JL, Hsieh TY. Chylothorax as the initial presentation of systemic lupus erythematosus: a case report. Clin Rheumatol. 2007;26(8):1373-1374.
  4. Narita Y, Naoki K, Hida N, et al. Case of bilateral chylothorax with systemic lupus erythematosus complicated by steroid-/ immunosuppressant-resistant pleural effusion [in Japanese]. Nihon Kokyuki Gakkai Zasshi. 2008;46:120-125.
  5. Manzella DJ, Dettori PN, Hertimian ML, Melero MJ. Chylous ascites and chylothorax as presentation of a systemic pro-gression of discoid lupus. J Clin Rheumatol, 2013,19, 87-89.
  6. Soysal DE, Hizar Turan S, Ozmen M et al. A rare case of systemic lupus erythematosus with chylous ascites and chylothorax. Case Rep Rheumatol 2013:797696.
  7. Chennadi S, Charoenpong P, Zulqarnain S. Systemic lupus erythematosus (SLE) with refractory bilateral chylothorax and chylous ascites.CHEST J.2016;150(4_S):574A-A.
  8. Song P, Zhang J, Shang C, et al. Refractory chylous pleural effusion with systemic lupus erythematosus: surgical treatment when steroid/immuno- suppressant resistant. Z Rheumatol 2019;78:797-802.
  9. Jiang AA,Sweeney DA, Chylothorax and Chylous Ascites Secondary to Systemic Lupus Erythematosus Without Lymphatic Obstruction. American Journal of Respiratory and Critical Care Medicine 2020;201:A6701.
  10. Zhang GH, Zhang LL, Wang YH,Shen WB. Clinical character-istics of systemic lupus erythematosus with chylothorax and/or chylous ascites: An analysis of 15 cases in China. Med-icine (Baltimore) 2020 Dec 18;99(51):e23661 doi:10.1097/MD.0000000000023661
  11. Petri M, Orbai AM, Alarcón GS, et al. Derivation and valida-tion of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Ar-thritis Rheum 2012; 64:2677
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.