Thrombotic Thrombocytopenic Purpura and Systemic Lupus Erythematosus – A Rare Association

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder characterized by a pentad of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, renal dysfunction, neurological symptoms, and fever. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease primarily affecting young females, involving multiple organ systems due to immune complex deposition and autoantibody-mediated tissue damage. The coexistence of SLE and TTP is rare but presents a significant diagnostic and therapeutic challenge. We report a case of an 18-year-old female presenting with fever, menorrhagia, and neurological deficits. Despite platelet transfusions, her cytopenia persisted. Laboratory investigations revealed hemolysis, ANA positivity, and MRI brain abnormalities. Due to financial constraints, plasmapheresis could not be performed, and the patient was successfully treated with corticosteroids and cyclophosphamide. This case highlights the importance of early recognition and alternative treatment strategies in resource-limited settings.