# Atypical Presentation of Thrombotic Thrombocytopenic Purpura (TTP) as an Initial Manifestation of Systemic Lupus Erythematosus (SLE) in a Young Male

## TL;DR

A young man with no prior health issues was diagnosed with TTP, which later revealed an underlying SLE, highlighting a rare initial presentation of the disease.

## Contribution

This case report highlights the rare initial manifestation of SLE as TTP in a young male with no prior medical history.

## Key findings

- The patient presented with altered mental status, headache, and right-sided numbness, leading to a TTP diagnosis.
- Further evaluation revealed the presence of SLE, indicating a rare initial manifestation of the disease.
- The case underscores the need for a comprehensive diagnostic approach when TTP is suspected.

## Abstract

Thrombotic thrombocytopenic purpura (TTP) is a rare but life-threatening hematologic disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, neurologic symptoms, renal impairment, and fever. The etiology of TTP often involves a severe deficiency in ADAMTS13 activity, resulting in the accumulation of ultra-large von Willebrand factor multimers and subsequent microvascular thrombosis. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organ systems, and although the initial presentation of SLE with TTP is rare, it necessitates a comprehensive diagnostic and therapeutic approach. We present a case of a 27-year-old male with no significant past medical history who developed altered mental status, headache, and right-sided numbness, leading to the diagnosis of TTP and subsequent detection of SLE.