[Hemorrhagic syndrome due to a heparin-like anticoagulant in a patient with systemic lupus erythematosus]

Abstract

Introduction: In systemic lupus erythematosus, hemostasis disorders are mainly thrombotic, but more rarely hemorrhagic.

Case report: A 25-year-old man presented with a macrophagic activation syndrome revealing a systemic lupus erythematosus, secondarily complicated by a hemorrhagic syndrome ; biological investigations revealed an increase thrombin time and an activated partial thromboplastin time, normalized by protamin neutralization in vitro, thus confirming the presence of a heparin-like anticoagulant. The hemostasis balance normalized after the specific treatment of lupus.

Conclusion: This rare anomaly of hemostasis balance has been described in blood cancers and solid cancers. This is the first description of a case associated with an autoimmune connective tissue disorder such as lupus. After one year of follow-up, no diagnosis of blood or solid cancer was made.

Keywords: Anticoagulant héparine-like; Hemorrhagic syndrome; Heparin-like anticoagulant; Lupus erythémateux disséminé; Macrophagic activation syndrome; Syndrome d’activation macrophagique; Syndrome hémorragique; Systemic lupus erythematosus.