SLE patient with opstructive jaundice and midle lobe atelectasis – case report

Aim:Non-specific symptoms like weaknes and clinical signs like high temperature in chronically ill patients with long history of seronegative spondiloarthropaty can be misleading because lot of side-effects of long-term therapy. Case report:Male patient, 54 year was admitted to the emergency department because of weaknes and elevated body temperature 38, 3ºC. Patient had three chronical diseases, 20 year long history of systemic lupus eritematodes (SLE), arterial hypertension and insulin-dependent diabetes mellitus. 19 years before partial pancreatectomy with pancreatojejunoanastomosis, cholecystectomy and splenectomy were performed because of necrotizing pancreatitis. Two years before this episode patient suffered of opstructive jaundice because of stenosis of anastomosis which was confirmed with endoscopic retrograde cholangiopancreatography (ERCP) and resolved with sphincterotomy and stenting of anastomosis. First chest X-ray at the admition showed pleural effusion in the right hemithoax base. First biochemistry tests revealed signs of hepatic function lesion, hyperbilirubinemia with 186µmol/L (norm.3-20). C-reactive protein (CRP) was highly elevated 231, 8mg/l (norm.