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Abstract
Case 2: A 19-year-old Caucasian female with falling cytopenia and fever A 19-year-old Caucasian girl presented to Emergency Room with low blood pressure, tachycardia, and a temperature of 40.5°C. She also had cervical microadenopathies and vasculitic chilblains in her hands. While she was being resuscitated, blood tests revealed hemoglobulin 8.9 g/dL, white cells 2100/µL, platelets 146,000/µL, AST/ALT 146/64, urinary protein/creatinine ratio 0.454, ferritin 11,791 pmol/L, prolonged aPTT 46.8s (N<28s) that was corrected by actin FS and fibrinogen 3.06 g/dL.
She had been unwell for the previous 3 months with low mood, ‘more to herself’, persistent low-grade fever in the previous month with a hard palate ulcer, myalgia and vasculitic chilblains.
Learning Objectives At the end of this workshop participants will be able to:
Explain the main challenges in the differential diagnosis of falling cytopenia and fever
Approach the initial management of falling cytopenia, fever and hyperferritinemia
Enhance clinical awareness of potential severe complications of hematological problems in SLE
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