Table 2: Case reports of massive pleural effusions as the presenting feature of SLE.

Year/Author	Clinical Presentation	Pleural fluid WBC	ANA	anti-dsDNA	C3	C4	Treatment	Outcome
Bouros [3]	20yo M with dyspnea and fevers ×1 week	500 × 10^6cells/L; 70% lymphocytes	1:350	pos	17.5 mg/dL	3.52 mg/dL	methylprednisolone 64 mg/day × 2 months then slowly tapered; cyclophosphamide 150 mg/day × 6 months, then 100 mg/day × 6 months	effusion resolved by 20 days, minimal pleural thickening remained
Mitra [12]	20yo F with dyspnea × 7 days	200-1970 × 10^6 cells/L; 20-40% lymphocytes, 60-80% neutrophils	1:160	98 ng/dL	NR	NR	prednisolone 1 mg/kg/day, maintained on chronic steroids	near complete resolution of pleural effusion at 4 weeks
Wan [5]	23yo F with cough and chest pain x1 week	NR	320X	1:620	35.5 mg/dL	< 10 mg/dL	prednisolone 2 mg/kg/day; methotrexate 7.5 mg/wk - subsequently maintained on prednisolone 10 mg/day	effusion decreased dramatically by 1 month
Chang [17]	66yo M with fever and dyspnea × 1-2 weeks despite levoquin for pneumonia.	340-2950 × 10^6cells/L ; 3-16% lymphocytes and 48-92% neutrophils	1:1280	1:160	dcr	dcr	methylprednisolone 1 mg/kg/day	complete resolution of pleural effusion and symptoms

YO: Year Old; M: Male; F: Female; NR: Not Reported; Pos: Positive; DCR: Decreased Serum Complement Levels (taken from the original publication, actual serum level not reported).