Unmasking Lupus: Intracranial Hemorrhage as the Primary Clue in an Adolescent With Refractory Thrombocytopenia—A Case Report

TL;DR

A 17-year-old girl with severe low platelet count and brain hemorrhage was diagnosed with lupus after a multidisciplinary treatment led to recovery.

Contribution

This case report highlights SLE as a rare but important cause of unexplained intracranial hemorrhage in adolescents with cytopenia.

Findings

SLE can present with cerebellar hemorrhage and severe thrombocytopenia in adolescents.

Prompt multidisciplinary treatment, including surgery and immunosuppression, led to dramatic recovery.

SLE should be considered in the differential diagnosis of unexplained CNS hemorrhage with cytopenia.

Abstract

Systemic lupus erythematosus (SLE) is a rare autoimmune disorder, rarely presenting with central nervous system (CNS) hemorrhage—especially cerebellar involvement. We report a previously healthy 17‐year‐old female presenting with severe thrombocytopenia and cerebellar hemorrhage, leading to a diagnosis of SLE. Recovery was dramatic and achieved by prompt multidisciplinary management, including neurosurgical intervention, immunosuppressive treatment, and intensive care. The case highlights the importance of considering SLE as a differential diagnosis of unexplained intracranial hemorrhage, particularly in adolescents presenting with cytopenia.

Figures