Childhood lupus with microangiopathic antiphospholipid syndrome and pulmonary hemorrhage.

BACKGROUND: Concurrent thrombotic and hemorrhagic manifestations are uncommon in patients with Antiphospholipid Syndrome.

CASE CHARACTERISTICS: A 10-year-old girl with fever, edema, rash and joint pains, who later developed deep venous thrombosis (DVT), stroke, thrombotic microangiopathic hemolytic anemia and pulmonary hemorrhage. Investigations confirmed Antiphospholipid syndrome associated with systemic lupus erythematosus.

OUTCOME: She went into complete remission with intravenous immunoglobulins, plasmapheresis, immunosuppression and anticoagulation.

MESSAGE: Thrombotic microangiopathic hemolytic anemia and anti-phospholipid syndrome can be the presenting manifestations of systemic lupus erythematosus.