因後天性凝血因子XIII缺乏導致反覆自發性肌肉內血塊在一位年老的全身性紅斑狼瘡患者

Clinical Images: recurrent spontaneous intramuscular hematoma by acquired coagulation factor XIII deficiency in an elder patient with systemic lupus erythematosus

An 84-year-old woman who had a 2-year history of systemic lupus erythematosus (SLE) with initial pleuritis, proteinuira, leukopenia, positive ANA (1:1280, homogenous pattern) and ds-DNA Ab was hospitalized 3 times in these 7 months because of recurrent spontaneous ecchymosis with painful swelling over different regions of limbs. At the first time, it developed mainly over the right thigh (Fig. 1A) with acute anemia (hemoglobin: 7.3 g/dL) and computed tomography (CT) showed large hematoma over the medial aspect of right thigh with intermuscular infiltration in medial and posterior compartments (arrows in Fig. 2A).