Abstract：
A 74-year-old man developed with left pleural effusion and was suspected of benign asbestos pleural effusion and tuberculous pleurisy. Because of elevation of ADA level in the pleural effusion, diagnostic treatment for tuberculous pleurisy by anti-tuberculosis drugs was performed. However, right pleural effusion, cutaneous/mucosal lesions, leukocytopenia, and fever elevation occurred. The pathology of skin biopsy was consistent with systemic lupus erythematosus (SLE). Since clinical findings did not improve even after discontinuation of all drugs, he received steroid therapy was started and clinical findings improved. He was suspected of late-onset SLE. In conclusion, lupus pleurisy should also be differentiated when pleural effusion is seen in older. Late-onset SLE and drug-induced lupus should be carefully differentiated based on the clinical course.
摘要：
一名74岁的男子出现左胸腔积液，怀疑患有良性石棉胸腔积液和结核性胸膜炎。由于胸腔积液中ADA水平升高，使用抗结核药物对结核性胸膜炎进行诊断性治疗.然而,右侧胸腔积液,皮肤/粘膜损伤，白细胞减少症,并出现发热升高。皮肤活检病理符合系统性红斑狼疮(SLE)。由于即使在停用所有药物后，临床结果也没有改善，他开始接受类固醇治疗，临床表现有所改善。他被怀疑患有迟发性SLE。总之,老年人出现胸腔积液时，也应鉴别狼疮胸膜炎。迟发性SLE和药物性狼疮应根据临床病程仔细区分。
