Abstract
Systemic lupus erythematosus (SLE) is a complex autoimmune disease that affects multiple organ systems in the body. We report the case of a patient with new-onset bilateral lower extremity (LE) non-pitting edema as the only presenting symptom of a severe SLE flare. Other potential etiologies of non-pitting LE edema in patients with SLE were excluded, including hypothyroidism and lymphedema. Laboratory investigations and SLE disease activity index (SLEDAI) score suggested severe SLE flare. The edema improved with steroids and diuresis. Clinicians should know that non-pitting LE edema can be the only manifestation of a multisystem SLE flare.