Case Presentation: A 61-year-old woman with a history of RA (on methotrexate and adalimumab) and latent TB (previously treated with Rifampin in 2023), presented with a three-month history of cough and shortness of breath. Imaging revealed bilateral pleural effusions and hypodense lesions in the spleen. Thoracentesis was performed, with pleural fluid analysis revealing a lymphocytic [...]