# 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.

## Key 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.