A A Systemic Lupus Erythematosus Accompanied with Myelodysplastic Syndrome,Grave’s Disease, and Sub-Acute Subdural Hemorrhage: A Case Report

Abstract

Background: The systemic lupus erythematosus (SLE) is a disease of
autoimmune etiology affecting multiple systems, involving most commonly
females of the reproductive age group and different clinical manifestations
in each individual. Case presentation: A 23-year-old female patient with
systemic lupus erythematosus (SLE) presented with myelodysplastic
syndrome (MDS), Grave’s disease, and sub-acute subdural hemorrhage
(SDH). She had chief complaints of severe headache and gum bleeding. Three
weeks earlier, the patient experienced a head injury. SLE was diagnosed on
biological and immunological clinical ACR criteria and the patient never had
a therapy before. Bone marrow aspiration (BMA) test was performed with
MDS result. Thyroid function test was performed with the result of decreased
Thyroid Stimulating Hormone (TSH) and increased FT4 with diffused
enlargement of thyroid gland. Brain CT Scan resulted in sub-acute SDH with
midline shift of 1.13 cm to the left. The patient underwent subdural drainage
with local anesthesia and received steroid, azathioprine, thiamazole and
non- selective beta-blocker. She was hospitalized for 21 days and was
discharged with good condition. Conclusion: Further investigation of the
patient is needed to fully understand the correlation between MDS, Subdural
Hemorrhage and Grave’s Disease in associated with SLE.