Chao Yi-Hsiang, Chen Hsin-Yu
Department of Surgery, Kaohsiung Veteran General Hospital, No. 386, Dazhong 1st Road, Zuoying District, Kaohsiung City 813, Kaohsiung, Taiwan.
Division of Nephrology, Department of Internal Medicine, Kaohsiung Veteran General Hospital, Kaohsiung, Taiwan.
J Formos Med Assoc. 2022 Dec;121(12):2633-2638. doi: 10.1016/j.jfma.2022.03.020. Epub 2022 Apr 19.
Pseudo-pseudo Meigs' syndrome (PPMS) exhibits patients with ascites, pleural effusion, elevated CA-125, and diagnosed of systemic lupus erythematosus (SLE) eventually without evidence of ovarian or pelvic tumor. It's a rare diagnosis but it has a good response to treatment. We here present an 82-year-old female, who was found to have ascites, pleural effusion, and elevated CA-125. CT of abdomen revealed absence of pelvic tumor. However, a rapid decline in renal function and progressive proteinuria were also observed. We performed an autoimmune-associated investigation. A diagnosis of late-onset SLE was made due to meeting the criteria of serositis, hemolytic anemia, thrombocytopenia, renal disease, and positive anti-smith antibody. We gave this patient a regimen with steroids and hydroxychloroquine. Both ascites and pleural effusion resolved in one month. PPMS is an important differential diagnosis in female patients with ascites, pleural effusion, and elevated CA-125. A survey of the pelvic tumor should be done first to exclude Meigs' syndrome or pseudo-Meigs' syndrome. SLE flare-up should be kept in mind even in the elderly.
假性假性梅格斯综合征（PPMS）表现为患者有腹水、胸腔积液、CA-125升高，最终被诊断为系统性红斑狼疮（SLE），但无卵巢或盆腔肿瘤证据。这是一种罕见的诊断，但对治疗反应良好。我们在此报告一名82岁女性，她被发现有腹水、胸腔积液和CA-125升高。腹部CT显示无盆腔肿瘤。然而，还观察到肾功能迅速下降和进行性蛋白尿。我们进行了自身免疫相关检查。由于符合浆膜炎、溶血性贫血、血小板减少、肾病和抗史密斯抗体阳性的标准，诊断为迟发性SLE。我们给予该患者类固醇和羟氯喹治疗方案。腹水和胸腔积液在一个月内消退。PPMS是腹水、胸腔积液和CA-125升高的女性患者的重要鉴别诊断。应首先进行盆腔肿瘤检查以排除梅格斯综合征或假性梅格斯综合征。即使是老年人也应牢记SLE发作。
