| Summary points: | A 40-year-old woman who initially presents with acute abdominal pain and lethargy, is referred for further evaluation to another hospital after re-presenting 3 weeks later with asthenia, fever, dyspnoea, and abdominal distension. Direct antiglobulin (Coombs) test results, laboratory data, blood cultures, virology tests, autoimmune screening, abdominal ultrasound, CT, echocardiogram with images, bone marrow aspirate, liver biopsy, and treatment are described, as is presentation and treatment of acquired haemophilia 4 weeks later. The authors stress the importance of recognising other autoimmune conditions associated with SLE, including myelofibrosis and acquired haemophilia and discuss the required multidisciplinary management to treat complications and stabilise the conditions. |
Multisystem Failure Due to Three Coexisting Autoimmune Diseases
