Systemic lupus erythematosus (SLE) is a systemic disease which affects mainly young females and can cause lifethreatening conditions. Pleural effusion can occur in SLE patients and usually tends to be mild and bilateral. This report aims to highlight the clinical presentation and medical management of massive unilateral pleural effusions in SLE patients. Here we report a 35-year-old female diagnosed with SLE for six years. She presented with shortness of breath, severe pleuritic chest pain, and fatigue. Her clinical examination showed signs of massive pleural effusion on the right side which was confirmed later by a chest x-ray and computer tomography of the chest. An echocardiography and abdominal ultrasound indicated no pericardial effusion and no ascites. A pleural fluid analysis showed exudative fluid. Sputum culture and polymerase chain reaction on blood sample for Mycobacterium tuberculosis were negative. She was also edematous and pale but not cyanotic or jaundiced. The treatment included blood transfusions, antibiotics, rituximab, azathioprine, and hydroxychloroquine. The pleural effusion responded well to rituximab, and she was discharged after two months in good condition.

Jaccoud's arthropathy (JA) is a condition characterized clinically by reversible joint deformities such as ulnar deviation, swan neck, thumb subluxation and hallux valgus, along with an absence of articular erosions on a plain radiograph. This report aims to highlight the clinical presentation and medical management of JA as well as to draw attention to the disease among clinicians. We are presenting a 57-year-old male, present with a history of episodes of pain and swelling in the metacarpophalangeal, proximal and distal interphalangeal joints for 20 years associated with joint stiffness for less than half an hour during the last 15 years. Clinical examination of the hand revealed joints swelling, ulnar deviation at wrist joints and fingers, Z shape deformity of thumbs, swan neck deformity of little fingers and visible wasting of thinner muscles, although there is no tenderness or skin change and all hand deformities were correctable.