title: Successful treatment of early secondary myelofibrosis in SLE with IVIG.
abstract: Myelofibrosis has been reported as a rare cause of pancytopenia in patients with autoimmune diseases. We describe a 54y old female patient who was admitted with severe anemia subsequently found to be due to marrow fibrosis. During the course of her hospitalization, relying both on her clinical symptoms as well as the results of a wide range of laboratory tests and diagnostic procedures, the diagnosis of systemic lupus erythematosus was established. The patient was treated with high dose steroids, but improvement of her clinical symptoms as well as normalization of her peripheral blood count were achieved only after high dose intravenous therapy with gamma globulin (IVIG) was instituted. Along with the improvement in the peripheral blood parameters normalization of the bone marrow architecture was recorded on a repeated bone marrow biopsy. IVIG therapy should be considered in extreme cases of bone marrow suppression in SLE.
authors.affiliation: Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Aharon
authors.forename: Y
authors.initials: Y
authors.lastname: Levy
authors.forename: Y
authors.initials: Y
authors.lastname: Bar-Dayan
authors.forename: A
authors.initials: A
authors.lastname: Afek
authors.forename: G
authors.initials: G
authors.lastname: Zandman-Goddard
authors.forename: Y
authors.initials: Y
authors.lastname: Skurnik
authors.forename: F
authors.initials: F
authors.lastname: Fabrrizzi
authors.forename: Y
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008875:Middle Aged; D055728:Primary Myelofibrosis / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D012155:Reticulin / Q000032:analysis
chemical_list: D016756:Immunoglobulins, Intravenous; D012155:Reticulin