Abstract
Budd-Chiari syndrome (BCS) is a scarce but severe condition characterized by the obstruction of the hepatic veins, liver congestion, and consequent damage. This series brings up one unusual presentation of BCS associated with autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), and lupus nephritis (LN), which collectively complicate the clinical scenario. This is a 19-year-old woman who was admitted for abdominal pain, hepatomegaly, ascites, and jaundice. Her history included the diagnosis of systemic lupus erythematosus. Laboratory findings revealed hemolytic anemia, thrombocytopenia, and impaired renal function. Imaging investigations were done to prove the diagnosis of BCS. The patient's complex autoimmune profile, characterized by the simultaneous presence of AIHA and ITP with LN, underlined the multifaceted nature of her condition. This case underscores the diagnostic and therapeutic challenges posed by the co-existence of BCS with AIHA, ITP, and LN, highlighting the critical role of a multidisciplinary approach in managing such complex cases effectively. Timely diagnosis and targeted treatment strategies are essential for improving outcomes in these patients.