Hematologic aspects of systemic lupus erythematosus. Current concepts

Ann Intern Med. 1977 Feb;86(2):220-9. doi: 10.7326/0003-4819-86-2-220.

Abstract

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.

MeSH terms

  • Agglutinins / analysis
  • Anemia, Hemolytic / etiology*
  • Autoantibodies / analysis
  • Autoimmune Diseases
  • Blood Coagulation
  • Blood Platelets / physiopathology
  • Cell Survival
  • Cold Temperature
  • Coombs Test
  • Cryoglobulins / analysis
  • Humans
  • Immunoglobulins / analysis
  • Leukocyte Count
  • Leukopenia / etiology*
  • Lupus Erythematosus, Systemic / blood*
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / immunology
  • Lymphocytes
  • Splenectomy
  • Thrombocytopenia / etiology*
  • Viscosity

Substances

  • Agglutinins
  • Autoantibodies
  • Cryoglobulins
  • Immunoglobulins