A Rare Case of Polyserositis With Elevated Serum Cancer Antigen (CA)-125 in Systemic Lupus Erythematosus: A Case Report of Pseudo-Pseudo Meigs Syndrome

Pseudo-pseudo Meigs syndrome (PPMS) is a rare condition characterized by pleural effusion, ascites, and elevated cancer antigen (CA)-125 levels in the setting of systemic lupus erythematosus (SLE) without evidence of ovarian tumors. We report a case of a 24-year-old woman with a known history of SLE for three years. Her symptoms were well-controlled with prednisolone and hydroxychloroquine. She presented with a history of shortness of breath, diffuse abdominal pain, and abdominal distension. Initial diagnostic workup revealed ascites, elevated CA-125 levels, and pleural effusion, without evidence of malignancy. A series of confirmatory tests excluded other differential diagnoses, leading to a diagnosis of PPMS. The patient was treated initially with furosemide without improvement. After confirming the diagnosis, methylprednisolone and oral prednisone were then administered with a favorable prognosis. This case contributes to the literature by highlighting PPMS as an important differential diagnosis to be considered in patients with SLE. Early recognition is crucial to minimize the need for unnecessary invasive procedures. The goal is to initiate the appropriate management as early as possible to optimize patient outcomes.