Case Report

Thrombocytopenia and Deep Vein Thrombosis on the Top of an Iceberg

Thrombocytopenia and deep vein thrombosis


Systemic Lupus Erythematous (SLE) is a chronic autoimmune disorder with a relapsing- remitting course. Besides, SLE most commonly occurs in child-bearing-age women. Due to protean manifestations, the diagnosis may be challenging; however, a high index of suspicion, i.e. achieved by experience and perceptivity is the key to a correct decision. Here, we present an SLE patient; her initial symptoms resembled a malignant process, but important elements guided us to the underlying autoimmune process. A 34-year-old woman presented with a uterine mass, deep vein thrombosis, and significant thrombocytopenia. Our first impression was malignant processes; however, considering her age with thrombosis and thrombocytopenia as the key components of her presentation, we suspected antiphospholipid syndrome and SLE. Her abdominal mass was a benign leiomyoma. We treated her with glucocorticoids and anticoagulants. Accordingly, after improving cytopenia, we discharged her and the follow-up examination result was satisfactory.

[1] Cojocaru M, Cojocaru IM, Silosi I, Vrabie CD. Manifestatons of systemic lupus erythematosus. Maedica. 2011; 6(4):330-6. [PMID] [PMCID]
[2] Al Arfaj AS, Khalil N. Clinical and immunological manifestatons in 624 SLE patents in Saudi Arabia. Lupus. 2009; 18(5):465-73. [DOI:10.1177/0961203308100660] [PMID]
[3] Jung JH, Soh MS, Ahn YH, Um YJ, Jung JY, Suh CH, et al. Thrombocytopenia in systemic lupus erythematosus: Clinical manifestatons, treatment, and prognosis in 230 patents. Medicine. 2016; 95(6):e2818 [DOI:10.1097/MD.0000000000002818] [PMID] [PMCID]
[4] Bashal F. Hematological disorders in patents with systemic lupus erythematosus. The Open Rheumatology Journal. 2013; 7:87-95. [DOI:10.2174/1874312901307010087] [PMID] [PMCID]
[5] Al-Shahi R, Mason J, Rao R, Hurd C, Thompson E, Haskard D, et al. Systemic lupus erythematosus, thrombocytopenia, microangiopathic haemolytc anaemia and ant-CD36 antbodies. Rheumatology. 1997; 36(7):794-8. [DOI:10.1093/rheumatology/36.7.794] [PMID]
[6] Fayyaz A, Igoe A, Kurien BT, Danda D, James JA, Stafford HA, et al. Haematological manifestatons of lupus. Lupus Science & Medicine. 2015; 2(1):e000078. [DOI:10.1136/lupus-2014-000078] [PMID] [PMCID]
[7] Gomez-Puerta JA, Cervera R. Diagnosis and classifcaton of the antphospholipid syndrome. Journal of Autoimmunity. 2014; 48- 49:20-5. [DOI:10.1016/j.jaut.2014.01.006] [PMID]
[8] Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortn PR, et al. Derivaton and validaton of the Systemic Lupus Internatonal Collaboratng Clinics classifcaton criteria for systemic lupus erythematosus. Arthrits and Rheumatsm. 2012; 64(8):2677-86. [DOI:10.1002/art.34473] [PMID] [PMCID]
[9] Duhamel G, Dupoirieux J, Hopfner C, Dine G, Reznikoff M. [Associaton of autoimmune thrombopenic purpura and leiomyoma. Recovery afer excision of the tumor (French)]. Presse Medicale (Paris, France: 1983). 1984; 13(33):2005-7. [PMID]
[10] Bowles K, Turner G, Wimperis J. Resoluton of chronic severe refractory thrombocytopenia afer treatment of hypothyroidism. Journal of Clinical Pathology. 2004; 57(9):995-6. [DOI:10.1136/ jcp.2004.016543] [PMID] [PMCID]
[11] Hansen RJ, Balthasar JP. Mechanisms of IVIG acton in immune thrombocytopenic purpura. Clinical Laboratory. 2004; 50(3-4):133-40. [PMID]
IssueVol 6 No 1 (2021) QRcode
SectionCase Report(s)
Systemic lupus erythematosus (SLE) APS Deep venous thrombosis (DVT)

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Daraei M, Karimpour Reyhan S, Abbaszadeh M, Afshari A. Thrombocytopenia and Deep Vein Thrombosis on the Top of an Iceberg. CRCP. 2021;6(1):11-14.