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Pseudo-pseudo Meigs' syndrome (PPMS), also known as Tjalma syndrome, is an exceptionally rare condition marked by pleural effusion, ascites, and elevated CA-125 levels, usually in the context of systemic lupus erythematosus (SLE) without any associated ovarian tumors. We report the case of a 40-year-old woman who presented with a four-month history of fatigue, nausea, weight loss, abdominal pain, and pleural effusion. Initial diagnostic workup revealed ascites, elevated CA-125 levels, and pleural effusions, with no evidence of malignancy.

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Introduction: Systemic lupus erythematosus is a chronic inflammatory disease affecting women, causing gastrointestinal issues like acute pancreatitis, esophagitis, and protein-losing enteropathy. Protein loss is uncommon, but a case study shows protein-losing enteropathy as a first sign.

Importance: Protein-losing enteropathy (PLE) is a rare gastrointestinal manifestation of SLE, often seen years before diagnosis.

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Meigs syndrome after treatment for catamenial pneumothorax.

Gen Thorac Cardiovasc Surg Cases

November 2023

Department of Surgery, Imamitsu Homecare Clinic, 1-9-10 Imamitsu, Wakamatsu-Ku, Kitakyushu, 808-0071, Japan.

Article Synopsis
  • Catamenial pneumothorax (CP) is a rare condition affecting women, characterized by a collapsed lung associated with menstrual cycles, while Meigs syndrome (MS) involves benign ovarian tumors causing pleural effusion and ascites, and its exact causes are not well understood.
  • A 40-year-old Japanese woman was diagnosed with CP after experiencing dyspnea and undergoing surgery that revealed diaphragmatic foramens.
  • Ten years later, the same patient presented with chest pain and imaging showed signs of MS, leading to surgery that resolved her symptoms, highlighting the rare occurrence of both conditions in one patient and suggesting links between them.
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We present a 39-centimeter thecoma with ascites and elevated Ca-125 values which is compatible with an atypical/incomplete Meigs' syndrome. Giant ovarian masses with elevated Ca-125 values and ascites are an alarming combination, although Gynecologists should be aware that there are also benign entities that mimic advanced stage ovarian cancer.

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Article Synopsis
  • - The case report discusses a postpartum woman suffering from pseudo-Meigs' syndrome (PMS) characterized by symptoms like abdominal pain, significant ascites, and hypercoagulation.
  • - Treatment with emergency anticoagulation led to improvements, such as the resolution of ascites and abdominal pain, despite the presence of a large degenerating uterine fibroid.
  • - Pathological analysis post-surgery confirmed the diagnosis, and ongoing research is recommended to explore the link between hypercoagulable states and PMS in pregnant patients.
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