Severe pleuritis and pericarditis associated with very‐late‐onset systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a multisystem disorder, which occurs mostly in young women. However, late‐onset SLE does exist and sometimes presents with an atypical, diversified course. We describe an 85‐year‐old woman who was admitted to our hospital for lower extremity edema and hand grip weakness. Chest computed tomography scan 4 days after admission demonstrated rapid accumulation of pleural and pericardial effusions, which did not exist on admission. She was diagnosed with pleuritis and pericarditis associated with very‐late‐onset SLE. Methylprednisolone pulse therapy resulted in a drastic improvement in serositis. Our case exemplifies the fact that patients with late‐onset SLE sometimes follow an atypical course, which makes the clinical diagnosis difficult.