Severe Epistaxis, Atypical Presentation of Lupus Hepatitis

Lupus hepatitis is a rare manifestation of systemic lupus erythematosus. When present, it manifests as frustrating clinical signs and moderate disturbance of liver function. We describe a case of lupus hepatitis revealed by massive epistaxis secondary to hepatocellular failure in a 35-year-old female patient whose diagnosis of lupus was made secondarily. Management consisted of azathioprine and corticosteroids, with good resolution of clinical and laboratory signs.