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Unusual presentation of Thrombotic Thrombocytopenic Purpra in a newly diagnosed pediatric patient with Systemic Lupus Erythematosus in the setting of MIS-C
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  • Eman Al-Antary,
  • Rewa Arar,
  • Yogindra Persaud,
  • Basil Fathalla,
  • Madhvi Rajpurkar,
  • Kanta Bhambhani
Eman Al-Antary
Children's Hospital of Michigan

Corresponding Author:[email protected]

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Rewa Arar
Children's Hospital of Michigan
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Yogindra Persaud
Children's Hospital of Michigan
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Basil Fathalla
Children's Hospital of Michigan
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Madhvi Rajpurkar
Children's Hospital of Michigan
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Kanta Bhambhani
Children's Hospital of Michigan
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Abstract

The understanding of Coronavirus disease 2019 (COVID-19) immune dysregulation is evolving. Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with alternations in both innate and adaptive immunity, probably caused by a complex interplay of genetics and environmental exposure with various triggers. A rare hematological complication of SLE as well as recently reported in adult with COVID-19 is thrombotic thrombocytopenic purpura (TTP). We report a pediatric case with features suggestive of multisystem inflammatory syndrome in children (MIS-C) with coronary artery ectasia, TTP, autoimmune hemolytic anemia (AIHA) and thrombocytopenia with new onset SLE as well.