Case Presentation A 36-year-old man with a known history of systemic lupus erythematosus (SLE) presented with an 8-month history of progressive urinary frequency, urgency, and suprapubic pain. Presentation to the Emergency Department Intractable vomiting and diarrhea for two weeks prior to admission Symptoms started after a day of binge drinking (>5 drinks of hard liquor) Reported progressive worsening of symptoms without improvement Hospital Course (Initial Days) Prior to hospitalization, SLE was managed with hydroxychloroquine 200 mg once daily and prednisone 20 mg twice daily During the first day of hospitalization, the patient reported worsening urinary symptoms with increased urinary effort and low urinary output Physical Examination Afebrile, stable vital signs Laboratory Findings Serum creatinine: 1.49 mg/dL Urine protein: >1000 g/day Hematuria: >10 RBC/HPF Urinalysis: Pyuria,…