Abstract: The incidence of Mycobacterium tuberculosis infections among Systemic Lupus Erythematosus (SLE) patients is commonly observed due to the immunocompromised state of SLE patients [1]. Recent studies show that a history of tuberculous infections play a key role in the induction and exacerbation of SLE in genetically susceptible hosts thus acting as an immunomodulatory agent [2]. We report a case of a female patient with history of tuberculosis with an incidental diagnosis of SLE. The symptoms of SLE worsened after completing a six month course of Anti Tubercular Therapy (ATT) with standard drugs on par with RNTCP DOTS guidelines.