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A pregnant woman taking 5 mg of oral prednisone daily for stable systemic lupus erythematosus presented with severe pitting edema of both legs, a grade 2 systolic murmur, and a hemoglobin level of 6.8 g per deciliter. She was treated for kidney involvement with 300 mg of intravenous hydrocortisone a day and with azathioprine, but three weeks later pneumocystis pneumonia developed. She was treated with trimethoprim-sulfamethoxazole, and agranulocytosis developed.
References
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