Tjalma Syndrome-A Rare but Real Manifestation of Systemic Lupus Erythematosus

Tjalma syndrome, also known as pseudo-pseudo Meigs syndrome, is a rare complication of systemic lupus erythematosus (SLE) characterized by ascites, pleural effusion, and elevated CA-125 levels in the absence of malignancy. We report a case of a 22-year-old woman with SLE presenting with vulvar swelling, severe polyserositis, nephritis, and progressive respiratory failure. SLE was confirmed by strongly positive anti-dsDNA with low complement levels. Despite immunosuppressive and supportive therapy, the patient's condition rapidly worsened, and she died due to hyperkalemia-induced ventricular fibrillation. This case highlights the diagnostic challenges of Tjalma syndrome, the need for thorough exclusion of malignancy, and the importance of early immunosuppression in preventing fatal outcomes.