Can you diagnose this mystery illness?
A 26-year-old woman presented to the emergency department with a 2-day history of generalized edema, worsening dyspnea, chest pain, and nonproductive cough. The patient was tachycardic and tachypneic but afebrile.
Her peripheral oxygen saturation was 94% on 40% supplemented oxygen, and she appeared obtunded. An effusion at the level of the heart, abdomen, and lungs was confirmed.
She had a 6-month history of inflammatory joints, including the interphalangeal joints, knees, and elbows, for which she was prescribed glucocorticoids. She also had what appeared to be a case of urethritis. Symptoms waxed and waned.