Systemic Lupus Erythematosus (SLE) with Acute Nephritis, Antineutrophil Cytoplasmic Antibody- (ANCA-) Associated Vasculitis, and Thrombotic Thrombocytopenic Purpura (TTP): A Rare Case Report with Literature Review

Table 1

Laboratory test results within 24 hours.

Variable	Result	Reference range, adults
White blood cell (WBC)	5.5 bil/L	3.3–10.7 bil/L
Hemoglobin	12.1 g/dL	12.1–15.0 g/dL
Platelets on presentation	25 bil/L	150–400 bil/L
Platelets 9 hours after presentation	9 bil/L	150–400 bil/L
Creatinine	0.83 mg/dL	0.60–1.40 mg/dL
Total bilirubin	1.8 mg/dL	0.3–1.2 mg/dL
Direct bilirubin	0.6 mg/dL	0.0–0.3 mg/dL
Beta-human chorionic gonadotropin	<2 mIU/mL	0–5 mIU/mL
Erythrocyte sedimentation rate (ESR)	80 mm/hr	0–18 mm/hr
C-reactive protein (CRP)	5.6 mg/dL	0.0–0.8 mg/dL
Lactate dehydrogenase (LDH)	1,139 U/L	100–238 U/L
Haptoglobin	<8 mg/dL	40–240 mg/dL
D-dimer	>9,999 ng/mL	0–499 ng/mL
Prothrombin time (PT)	10.1 seconds	9.3–12.4 seconds
Partial thromboplastin time (PTT)	25.4 seconds	23.0–30.0 seconds
Schistocytes	3–5/hpf	<1/hpf
Fibrinogen	331 mg/dL	175–375 mg/dL
Reticulocytes	85 bil/L	21–100 bil/L
ANA titer	≥1 : 1280	<1 : 160
Anti-double stranded DNA (dsDNA)	1,021 IU/mL	0.0–99.9 IU/mL
Complement C3	54 mg/dL	80–200 mg/dL
Complement C4	7 mg/dL	12–43 mg/dL
Urinalysis protein	>300 mg/dL	0 mg/dL
Urinalysis blood	3+	0
Urinalysis red blood cells (RBC)	>50/hpf, no RBC casts	0–2/hpf