A 34-year-old patient after vacation in Crimea has developed severe pain in her elbow joints, dyspnea and weakness. Body temperature is 37,6°C, skin pallor and erythema on the cheeks and bridge of nose are observed, lip mucosa is ulcerated. The joints are not visibly deformed, movement of the right elbow joint is restricted. Pleura friction sound is detected in the lungs on the right side below the angle of scapula. Heart sounds are dull, tachycardia, gallop rhythm, heart rate -114/min, Bp - 100/60 mm Hg. The most likely diagnosis is:

Answer options

1. Systemic lupus erythematosus
2. Infectious allergic myocarditis
3. Rheumatoid arthritis
4. Rheumatic carditis
5. Dry pleurisy

Explanation

Butterfly-type rash (erythema on the cheeks and bridge of the nose) on the face is a classic finding in SLE. Systemic Lupus Erythematosus (SLE), also known as lupus, is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary between people and may be mild to severe. Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a rash that is commonly on the face. This rash is termed the butterfly-type rash.