Severe Thrombocytopenia and Subdural Hematoma in Rhupus Syndrome: A Case Report

Zacarías-Mendoza N.V.; Díaz-Vargas G.Z.; Cáceres-Alpaca D.A. · Revista Medica Herediana (2026) · DOI: 10.20453/rmh.v37i2.7594

Resumen

Rhupus is a rare overlap syndrome of rheumatoid arthritis and systemic lupus erythematosus. Severe hematological and neurological manifestations are unusual and pose a diagnostic challenge. We present the case of a 58-year-old woman with long-standing joint deformities who developed ecchymosis, epistaxis, and progressive neurological impairment. Imaging studies revealed a subdural hematoma, and laboratory tests showed severe thrombocytopenia, elevated titers of rheumatoid factor and anti-CCP antibodies, as well as positive antinuclear antibodies. The patient met diagnostic criteria for both diseases. Following corticosteroid therapy and surgical evacuation of the hematoma, she progressed favorably and was discharged on immunosuppressive therapy. This case highlights the importance of timely recognition of Rhupus syndrome and the risk of life-threatening complications, underscoring the need for early multidisciplinary management. © The authors. Open access article, distributed under the terms of the Creative Commons Attribution 4.0 International License.

Instituciones: Universidad Peruana Cayetano Heredia