以出血為表現的全身性紅斑狼瘡

Systemic Lupus Erythematosus Presenting as Spontaneous Hemorrhage

後天第13（factor XIII, FXIII）凝血因子缺乏症是一種罕見、可能危及生命的出血性疾病，發病原因可能與自體免疫疾病、惡性腫瘤、藥物、近期手術和肝臟疾病有關。該病例描述了一名45歲女性，最初症狀是以左側骨盆腔血腫為表現，多方檢查後發現為FXIII凝血因子缺乏症，而FXIII凝血因子缺乏症的導因為全身性紅斑狼瘡，此案例強調了全身性紅斑狼瘡臨床表現的多樣性，特別是以凝血因子減少造成出血的罕見誘因，並探討了在治療過程中，平衡疾病控制與生育能力保護的重要性，特別是在育齡女性病人中，並顯示早期診斷及個別化治療對於提高預後的重要性。

Acquired Factor XIII (FXIII) deficiency is a rare, potentially life-threatening bleeding disorder that may be associated with autoimmune diseases, malignancies, medications, recent surgeries, and liver diseases. This case describes a 45-year-old female who initially presented with a left-sided pelvic hematoma. After multiple examinations, she was diagnosed with FXIII deficiency, which was caused by systemic lupus erythematosus (SLE). This case highlights the diverse clinical manifestations of SLE, particularly the rare trigger of bleeding due to decreased clotting factors. It also discusses the importance of balancing disease control and fertility preservation during treatment, especially in women of reproductive age, emphasizing the significance of early diagnosis and individualized treatment in improving prognosis.