Abstract
A 32 year old lady with a history of systemic lupus erythematosus (SLE ) complicated by crescentic lupus nephritis and end stage renal failure on thrice weekly haemodialysis, presented to the emergency department with breathlessness, chest pain and haemoptysis, stating that her symptoms had started roughly 24 hours earlier. She appeared anxious and in distress. BP was 160/105 mmHg, heart rate 105/min and there was evidence of bilateral rales and a gallop rhythm. She was afebrile but only 94% saturating on high flow oxygen.
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