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Splenectomy Does Not Cure the Thrombocytopenia of Systemic Lupus Erythematosus

STEPHEN HALL, M.B.B.S.; JOHN L. McCORMICK Jr., M.D.; PHILIP R. GREIPP, M.D.; CLEMENT J. MICHET Jr., M.D.; and CHARLES H. McKENNA, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Clement J. Michet, Jr., M.D.; Division of Rheumatology and Internal Medicine; Mayo Clinic, Rochester, MN 55905.


Rochester, Minnesota.


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;102(3):325-328. doi:10.7326/0003-4819-102-3-325
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Fourteen patients with systemic lupus erythematosus had splenectomies done between 1960 and 1982 for treatment of severe thrombocytopenia. Thrombocytopenia persisted or recurred within 1 month postoperatively in five patients and within 6 months in three others. Three patients had late recurrence (18, 30, and 54 months after splenectomy); in two it was probably related to withdrawal of immunosuppressive agents or corticosteroids. Median lowest platelet count before splenectomy and median platelet count at relapse or failure of splenectomy were both 8000/μL. Only two patients maintained normal platelet counts without need for corticosteroids or other treatment. These results differ from those in patients with idiopathic thrombocytopenic purpura. Other treatments should be tried before splenectomy is done for thrombocytopenia in patients with systemic lupus erythematosus.

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