title: SLE presenting as multiple hemorrhagic complications.
abstract: A 24 year old female with hereditary spastic paraplegia presented with intermittent headache for one year. She also had lower abdominal pain and vomiting for two months. She was pale, had icterus and mild splenomegaly. On diagnostic evaluation she was found to have hemolytic anemia, thrombocytopenia and bilateral adrenal, subdural, soft tissue (scalp and orbit) hemorrhages due to systemic lupus erythematosus (SLE). However, antiphospholipid syndrome (APS) antibodies were negative. Bilateral adrenal hemorrhage without associated APS is a rare phenomenon in SLE. We describe a case of SLE presenting with sequence of rare hemorrhagic complications in concert.
authors.affiliation: Department of Internal Medicine, M.E.S. Medical College, Perinthalmanna, India drcamans@gmail.com.
authors.forename: M C
authors.initials: MC
authors.lastname: Abdulla
authors.affiliation: Department of Internal Medicine, M.E.S. Medical College, Perinthalmanna, India.
authors.forename: J
authors.initials: J
authors.lastname: Alungal
authors.affiliation: Department of Internal Medicine, M.E.S. Medical College, Perinthalmanna, India.
authors.forename: S
authors.initials: S
authors.lastname: Hashim
authors.affiliation: Department of Internal Medicine, M.E.S. Medical College, Perinthalmanna, India.
authors.forename: M M
authors.initials: MM
authors.lastname: Ali
authors.affiliation: Medical biotechnology Central Research Laboratory, M.E.S. Medical College, Perinthalmanna, India.
authors.forename: M
authors.initials: M
authors.lastname: Musambil
mesh_terms: D000328:Adult; D000743:Anemia, Hemolytic / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000209:etiology*; D006470:Hemorrhage / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy
keywords: Systemic lupus erythematosus; antiphospholipid syndrome; bilateral adrenal hemorrhage; hematologic changes; neuropsychiatric lupus; subdural hemorrhage