Pseudo-pseudo Meigs’ syndrome presenting with a combination of polyserositis, elevated serum CA 125 in systemic lupus erythematosus: A case report

RATIONALE: Combination of polyserositis and elevated serum CA 125 is common in tumor or infectious disease, but this clinical combination is also found in other diseases. It could be the initial manifestation of pseudo-pseudo Meigs’ syndrome (PPMS), which is characterized by the presence of polyserositis and raised CA-125 level in systemic lupus erythematosus (SLE). PATIENT'S CONCERNS: A 44-year-old Chinese female was admitted with three months history of painless abdominal distension accompanied by watery diarrhea 5–6 times daily, shortness of breath, fatigue, lower limb swelling, and 10 kg weight loss. The test results showed peripheral cytopenias, hypoproteinemia, renal dysfunction and elevated CA 125, antidouble-stranded DNA antibodies, and anti-Sjogren's syndrome A antigen antibody was positive. There is no evidence for the diagnosis of solid tumor according to the results of imaging modality and pathological examination. DIAGNOSIS: The patient was diagnosed as pseudo-pseudo Meigs syndrome. INTERVENTION: The patient received hormone, leflunomide, and Plaquenil therapy. OUTCOMES: The patient's symptoms were relieved and the laboratory index was improved after the treatment of hormone and immunosuppressant. LESSONS SUBSECTIONS AS PER STYLE: PPMS is characterized by the combination of serous effusion and elevated serum CA 125 with no evidence of tumor among SLE patients. Clinicians should be aware of the diagnosis of PPMS avoiding unnecessary anxiety or surgical interventions.