Lupus nephritis with spontaneously resolved bilateral pneumothorax and mediastinal emphysema

We report a 29-year-old female patient known to have lupus nephritis on immunosuppression and peritoneal dialysis who developed large bilateral spontaneous pneumothorax and mediastinal emphysema. The patient showed signs of tension pneumothorax and pneumomediastinum; however, she adamantly refused chest tubes insertion. Recovery was noted within 18 h of high-flow oxygen with normalization of chest image.