Page 32 - MRS Abstracts March 2023

Rheumatological manifestation included alopecia, recurrent oral ulcers and Raynaud’s. Blood workup showed lymphopenia, raised inflammatory markers, positive ANA (1:320 homogenous pattern), raised dsDNA (368), and negative ENA.
Results:
Given the above, a diagnosis of SLE was made. Elevated CA125 levels have been reported in Tjalma syndrome which may be related to activation of cytokine leading to overexpression of CA-125 in the mesothelial cells which line the body's serous cavities and internal organs. Treatment with oral steroids, HCQ, and Azathioprine resulted in dramatic improvement.
Conclusions:
Tjalama syndrome is a rare subset of SLE. In our case, it was the initial presentation of SLE .Our case highlights the complex clinical presentation of this condition which usually requires immunosuppression. Early recognition and awareness of this condition can prevent unnecessary investigations and timely management of organ threatening condition.
References:
1.Schmitt ,R.,Weichert ,W., Schneider ,W.,Luft, FC.,Kettritz, R.,2005. Pseudo-pseudo Meigs' syndrome. Lancet,366,p.1672
2.Kimura ,R.,Imadea ,K. ,Mizuno, T. et al.,Severe ascites with hypothyroidism and elevated CA125 concentration: A case report .Endo Journal ,54,pp.751-755