DANIEL R. BUDMAN, M.D.; ALFRED D. STEINBERG, M.D.
Anemia occurs in more than one half of patients with systemic lupus erythematosus and is usually attributed to "chronic disease." Approximately 10% of patients with a positive Coombs' test manifest clinically significant hemolysis. Leukopenia affects both granulocytic and lymphocytic lines and may be caused by autoantibodies. Nevertheless, enhancement of B lymphocyte function occurs in active disease, perhaps due to a loss of regulatory T cells. Most patients have increased production and increased peripheral destruction of thrombocytes, with a normal circulation platelet count. Thrombocytopenia is usually caused by increased destruction. Qualitative abnormalities of platelet aggregation also occur. Circulation anticoagulants are not rare; however, spontaneous bleeding is uncommon. The anticoagulants, immunoglobulins directed against clotting factors, assume importance for invasive procedures. Most clinically significant hematopoietic abnormalities can be suppressed by corticosteroids; however, splenectomy, or immunosuppressive agents, or both, may be indicated for patients who respond inadequately to corticosteroids.
BUDMAN DR, STEINBERG AD. Hematologic Aspects of Systemic Lupus Erythematosus: Current Concepts. Ann Intern Med. ;86:220–229. doi: 10.7326/0003-4819-86-2-220
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Published: Ann Intern Med. 1977;86(2):220-229.
Lupus Erythematosus, Rheumatology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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