Hematologic aspects of systemic lupus erythematosus. Current concepts.
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.
D000373:Agglutinins / Q000032:analysis; D000743:Anemia, Hemolytic / Q000209:etiology*; D001323:Autoantibodies / Q000032:analysis; D001327:Autoimmune Diseases; D001777:Blood Coagulation; D001792:Blood Platelets / Q000503:physiopathology; D002470:Cell Survival; D003080:Cold Temperature; D003298:Coombs Test; D003450:Cryoglobulins / Q000032:analysis; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D007958:Leukocyte Count; D007970:Leukopenia / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000150:complications / Q000276:immunology; D008214:Lymphocytes; D013156:Splenectomy; D013921:Thrombocytopenia / Q000209:etiology*; D014783:Viscosity
D000373:Agglutinins; D001323:Autoantibodies; D003450:Cryoglobulins; D007136:Immunoglobulins