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Reminder of important clinical lesson
Life-threatening retro-pharyngeal bleed in a case of systemic lupus erythematosus – an uncommon but important evil of a common disease
  1. Amruth Palla1,
  2. John Rogers2,
  3. Sindhu Singh2
  1. 1Department of Internal Medicine, Danbury Hospital, Danbury, Connecticut, United States
  2. 2Hematology and Oncology Department, Mary Babb Randolph Cancer Hospital, Morgantown, West Virginia, United States
  1. Correspondence to Dr Amruth Palla, Amruth.Palla{at}


Acquired inhibitors of coagulation are antibodies that interfere with the coagulation system either by functional inhibition of the activity of clotting factors or by their increased clearance from the plasma. They can be idiopathic or seen in various physiologic (pregnancy and postpartum) or pathologic states (systemic lupus erythematosus (SLE), malignancies, rheumatoid arthritis) and can result in a variety of haemorrhagic sequelae. SLE can be associated with antibodies to multiple clotting factors and bleeding though rare can be an important haematologic manifestation with life-threatening consequences in these patients.

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  • Competing interests None.

  • Patient consent Obtained.