Purpura Fulminans After Varicella Infection and Pulmonary Embolism After COVID-19 Infection in Familial Mediterranean Fever: Coincidence or Not?

anemia (hemoglobin 9.1 g/dL), normal platelet count (213 × 10 3 /UL), decreased lymphocyte count (1100/mm 3 ), elevated neutrophil count (9900/mm 3 ), and elevated acute-phase reactants (C-reactive protein 308 mg/dL and erythrocyte sedi-mentation rate 94 mm/h). Urinalysis, renal, and liver function tests were all normal. Penile arterial Doppler ultrasonography revealed a decrease in blood flow in the cavernous bod-ies. In coagulation parameters, prothrombin time (PT) was prolonged (15.7 seconds) and D-dimer level was elevated (18.8 µg/mL), but activated partial thromboplastin time (25.6 seconds) and fibrinogen (301 mg/dL) levels were normal. Protein C (PC) (64%), protein S (PS) (34%), and anti-thrombin-3 (AT-3) activity (42%) levels were all decreased and then normalized after 6 weeks from PF. Inherited risk factors (factor V Leiden and prothrombin G20210A) for thrombosis were screened and excluded. Neither the patient nor her family had a history of thrombophilia. Anti-nuclear antibody, antiphospholipid antibodies, anti-neutrophilic cytoplasmic antibody, rheumatoid factor, and human leukocyte antigen-B51 (HLA-B51) were negative, while complement levels were normal. Fresh-frozen plasma trans-fusion with empirical antibiotic therapy was started. During the follow-up, swelling on the legs developed, and deep-vein thrombosis was detected in the bilateral vena saphenous