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Peritoneal involvement is quite common in systemic lupus erythematosus (SLE). However, significant ascites as the predominant manisfestations of SLE is extremely rare, and very few cases have been reported. We describe a patient with SLE whose disease first manifested as longstanding, painless and intractable ascites. The ascites preceded the diagnosis of SLE by 3 years. The diagnosis of SLE should be considered in patients with the so called "idiopathic" ascites. Once diagnosed, the ascites seem to respond promptly to corticosteroids, however, prior to their administration other potential causes, especially infections and malignancy, should be ruled out.

Thirty-six patients were studied for the presence of the lupus anticoagulant and its possible clinical and laboratory associations. Seven patients were found to have the anticoagulant. These patients had a significantly increased incidence of both thromboembolic complications (5/7 vs. 2/29) and thrombocytopenia (4/7 vs. 4/29). None of them had a bleeding tendency. Except for these associations, patients with the anticoagulant did not differ from those without the anticoagulant by any demographic, clinical, or laboratory parameter. The present study confirms observations that SLE patients with the lupus anticoagulant have an increased risk of thrombosis.

Pericarditis is a common manifestation of systemic lupus erythematosus (SLE), however, tamponade seems to be extremely rare. A review of the English literature revealed 12 such cases and in 5 the tamponade was the presenting symptom of the disease. We describe an additional patient. She developed pericardial tamponade one week after delivery of a healthy child, and subsequently was diagnosed to have SLE. The effect of pregnancy and the postpartum period on SLE is discussed.

A patient with systemic lupus erythematosus was first diagnosed after she had developed the Budd-Chiari syndrome. We believe that the Budd-Chiari syndrome was part of her tendency for thrombosis, induced by the presence of a lupus anticoagulant. The association between enhanced thrombosis and the lupus anticoagulant is discussed, and the need for prompt recognition and administration of anticoagulant therapy is emphasised.

Severe congestive cardiomyopathy is an uncommon complication of systemic lupus erythematosus (SLE). We describe a patient with active SLE and a circulating anticoagulant. She presented with a rapidly progressive cardiomyopathy, complicated by an intracavitary thrombus and cerebral infarction. The course of the disease is described, with special emphasis on the usefulness of consecutive echocardiographic studies.