This case illustrates a complexity of confounding and overlapping symptoms that can masquerade as another diagnosis. A 56-year-old African American man with persistent dyspnea and leg edema was hospitalized three times in a period of 6 months. The patient was treated for asthma, chronic obstructive pulmonary disease, and congestive heart failure. Hypertension and peptic ulcer disease were treated also. Complete clinical improvement was not observed. A careful review of his last admission and current admission clinical presentation and laboratory evaluation revealed a systemic manifestation and laboratory findings consistent with atypical systemic lupus erythematosus.