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Systemic lupus erythematosus (SLE) is a common systemic disease in the rheumatologic field. Serositis and gastrointestinal symptoms are common manifestations of SLE; however, polyserositis concurrently with acute acalculous cholecystitis is a rare and usually underestimated entity that can be associated with SLE. Medical treatment with steroids is efficacious and, in most instances, cholecystectomy can be avoided. We present the case of a young female patient with polyserositis and acute acalculous cholecystitis secondary to undiagnosed SLE, who eventually required surgical laparoscopic intervention and improved with immunosuppressive treatment.

Sjogren Syndrome (SS) is an autoimmune rheumatic disease, whose hallmark is ocular and mouth dryness secondary to autoimmune exocrinopathy. Rarely, SS can affect both peripheral nervous system (PNS) as well as central nervous system (CNS). When CNS is involved, SS is usually diagnosed after patients present with neurologic symptoms. Both ischemic and hemorrhagic stroke can present as first manifestation of primary SS. Stroke is described in literature as a rare entity associated with primary SS, and only few cases were reported. In some cases, CNS involvement was thought to be related to CNS vasculitis, but most of the times remains questionable. We present a rare case of intracranial hemorrhage as first manifestation of primary SS and a review of the pertinent literature.