Presentation
Known case of SLE presented with acute shortness of breath.
Patient Data
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Flask-shaped enlargement of the cardiac silhouette in keeping with pericardial effusion. Obliteration of the left costophrenic sulcus in keeping with probable pleural effusion.
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A huge large circumferential pericardial effusion is noted.
Mildly enlarged and increase in number of bilateral axillary lymph nodes and suggestion of increased number of mediastinal lymph nodes, however, evaluation is limited due to lack of IV contrast.
The left lower lobe atelectasis is noted due to a small left sided pleural effusion. Small trace of right sided pleural fluid.
No masses or consolidation is seen.
Mild pulmonary edema.
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There is a large circumferential pericardial effusion with signs suggestive of early tamponade.
Structurally normal aortic, mitral, tricuspid and pulmonic valves with trace tricuspid and pulmonic regurgitation.
Normal chamber dimensions with normal right and left ventricular systolic function, estimated LV EF is 60-65%.
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Decreased amount of pericardial effusion after insertion of a drainage catheter.
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US-guided renal biopsy.

Left perinephric hematoma as a complication of renal biopsy.
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Normalization after treatment.
Case Discussion
Kidney biopsy: Lupus nephritis class IV-G (A).