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Résumé Introduction Les anomalies de l'hémostase chez le patient lupique sont majoritairement de nature thrombotique mais plus rarement hémorragique. Observation Nous rapportons le cas d'un homme de 25 ans présentant un syndrome d'activation macrophagique révélateur d'un lupus érythémateux systémique et compliqué secondairement d'un syndrome hémorragique avec un allongement du temps de thrombine et du temps de céphaline activée, corrigés in vitro par l'ajout de protamine, confirmant ainsi la présence d'un anticoagulant « héparine-like ». Le bilan d'hémostase s'est normalisé après traitement spécifique du lupus. Conclusion Cette anomalie rare du bilan d'hémostase est connue dans les hémopathies et cancers solides. Il s'agit de la première description au cours d'un lupus. Après un an de recul, aucun diagnostic d'hémopathie ou de néoplasie solide n'a été porté. Abstract Introduction In systemic lupus erythematosus, hemostasis disorders are mainly thrombotic, but more rarely hemorrhagic. Case report A 25-year-old man presented with a macrophagic activation syndrome revealing a systemic lupus erythematosus, secondarily complicated by a hemorrhagic syndrome ; biological investigations revealed an increase thrombin time and an activated partial thromboplastin time, normalized by protamin neutralization in vitro, thus confirming the presence of a heparin-like anticoagulant. The hemostasis balance normalized after the specific treatment of lupus. Conclusion This rare anomaly of hemostasis balance has been described in blood cancers and solid cancers. This is the first description of a case associated with an autoimmune connective tissue disorder such as lupus. After one year of follow-up, no diagnosis of blood or solid cancer was made. [ABSTRACT FROM AUTHOR]

Introduction. – Systemic lupus erythematosus is still of unknown origin. Viruses have long been postulated to play a role in its pathogenesis particularly cytomegalovirus and Epstein-Barr virus.Exegese. – We describe three patients who presented acute onset of syste´mic lupus erythematosus concurrently with recent viral infection (two with cytomegalovirus and one with Epstein-Barr virus).Conclusion. – The peculiar clinical events emphasize the difficulty of diagnosis at the onset of the disease and suggest possible role of these viruses in the pathogenesis of SLE. [Copyright &y& Elsevier]