La progressione silenziosa di una trombocitopenia

The paper reports the case of a 13-year-old girl affected by epilepsy who presented with severe thrombocytopoenia, petechiae and multi-organ involvement, including acute renal failure, polyserositis and hepatosplenomegaly. After ruling out DRESS syndrome, thrombotic microangiopathies and haematological malignancies, the presence of bilinear cytopenia, hypocomplementemia and polyclonal hypergammaglobulinemia pointed toward the diagnosis of new-onset Systemic Lupus Erythematosus (SLE). Serological confirmation (positive ANA and anti-dsDNA) led to successful treatment with corticosteroids and dialysis. This case emphasises that silently progressing thrombocytopenia associated with renal involvement should prompt early consideration of systemic rheumatic diseases and that the more frequent diagnosis of post-viral thrombocytopenia in paediatric patients should be disregarded.