The Patient with Systemic Lupus Erythematosus
A 12-year-old black girl with no significant past medical history presented with the sudden onset of headache and lethargy. Her laboratory work showed thrombocytopenia (platelet count 8000/mm3). The hematologic differential diagnosis included idiopathic thrombocytopenic purpura and systemic lupus erythematosus. During evaluation the platelet count decreased to 5000/mm3. A CT scan showed a frontal intra-parenchymal hemorrhage. The patient developed hemiparesis, aphasia, and a dilated pupil. Dexamethasone 20mg was given and she was scheduled for emergency exploratory craniotomy. The presumptive diagnosis was hematoma caused by disruption of an arteriovenous malformation, most probably related to systemic lupus erythematosus.
KeywordsSystemic Lupus Erythematosus Lupus Nephritis Lupus Anticoagulant Black Girl Immune Complex Disease
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