An interesting case of systemic lupus erythematosus presenting with hypercalcemia: A diagnostic dilemma

Background: Hypercalcemia is common in primary hyperparathyroidism malignancies and even in tuberculosis. Interestingly, systemic lupus erythematosus (SLE) rarely presents with hypercalcemia. Case Report: We describe an interesting case of SLE in a patient who was otherwise thought to have either tuberculosis or a malignancy. The patient initially presented with feeling unwell, with generalized lymphadenopathy, bilater- al pleural effusion, and bilateral corneal calcium deposits secondary to severe hypercalcemia. The diagnosis of SLE was made based on positivity of antinuclear antibodies (ANA) and anti-dsDNA, the presence of serositis, lymphadenopathy, autoimmune hemolytic anemia, and constitutional symptoms. She was treated with ste- roids, with tremendous improvement in her general well-being, resolution of lymphadenopathy and pleural ef- fusion, and normalization of her hemoglobin and serum calcium. The atypical presentation of SLE with hyper- calcemia with pleural effusion is discussed.Conclusions: SLE should be one of the differential diagnoses in patients presenting with severe hypercalcemia.