We report a case of systemic lupus erythematosus in a 27-year-old female complicated with pneumonia and severe respiratory failure, requiring treatment in an intensive care unit and non-invasive ventilation. Symptoms developed in an otherwise healthy female with no comorbidities except recurrent oral ulcers. Despite evidence of pulmonary infection, response was noted only after early introduction of intensive immunosuppressive treatment. Differential diagnosis and treatment of this condition represent a real challenge but close co-operation between the intensive care unit, pulmonology, and rheumatology departments reduce the risk of a fatal outcome.
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