Concurrent occurrence of chylothorax, chylous ascites, and protein-losing enteropathy in systemic lupus erythematosus

Abstract

We describe 2 patients with systemic lupus erythematosus (SLE) who presented with chylothorax, chylous ascites, and protein-losing enteropathy. Analysis of pleural or peritoneal fluid revealed a high level of triglyceride and elevated 24 h stool alpha1-antitrypsin clearance in keeping with protein-losing enteropathy. One patient failed to respond to high dose corticosteroid therapy but recovered after 3 cycles of monthly cyclophosphamide treatment. The other patient initially responded to high dose corticosteroid therapy, but succumbed to infectious complications. This is the first report of occurrence of chylothorax and chylous ascites associated with SLE.