title: Bone marrow abnormalities in systemic lupus erythematosus with peripheral cytopenia.
abstract: OBJECTIVE
  Peripheral cytopenia is frequently found among patients with systemic lupus erythematosus (SLE). Bone marrow examination is usually considered in most cases; however, the incidence and association between cytopenia and disorders of the bone marrow remain unclear. We therefore conducted a prospective, cross-sectional, analytical study among patients with SLE and peripheral cytopenia to determine the incidence of bone marrow abnormalities and to find predictive factors for bone marrow examination.
  
  
  RESULTS
  Of the 41 patients, 20 had bone marrow abnormalities that could be categorised into six groups: hypocellularity (50%), plasmacytosis (35%), haemophagocytosis (30%), dyserythropoiesis (10%), aplastic marrow (10%) and myelofibrosis (5%). Most of the patients (75.6%) had moderate to severe, active disease and recovery from the cytopenia occurred after treatment of the SLE. None of the clinical factors was statistically proven to be associated with bone marrow abnormalities; however, 3 factors indicated an active disease status including (a) the SLEDAI score (b) the number of organs involved and (c) previous immunosuppressive drug therapy. All of these are potentially predictive factors of bone marrow abnormalities.
  
  
  CONCLUSIONS
  The incidence of bone marrow abnormalities is high among patients with SLE and peripheral cytopenia. Bone marrow may be one of the common targets of organs affected by immune mechanisms in active SLE. Peripheral cytopenia can be subsequently improved after treatment of the disease; therefore, bone marrow examination should be recommended among patients whose cytopenia does not recover after conventional therapy.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. chinwanit@yahoo.com
authors.forename: Chinadol
authors.initials: C
authors.lastname: Wanitpongpun
authors.forename: Nattiya
authors.initials: N
authors.lastname: Teawtrakul
authors.forename: Ajanee
authors.initials: A
authors.lastname: Mahakkanukrauh
authors.forename: Sarithorn
authors.initials: S
authors.lastname: Siritunyaporn
authors.forename: Chittima
authors.initials: C
authors.lastname: Sirijerachai
authors.forename: Kanjana
authors.initials: K
authors.lastname: Chansung
mesh_terms: D000293:Adolescent; D000328:Adult; D001853:Bone Marrow / Q000473:pathology*; D001855:Bone Marrow Diseases / Q000453:epidemiology* / Q000473:pathology; D001856:Bone Marrow Examination; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007970:Leukopenia / Q000453:epidemiology* / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013785:Thailand / Q000453:epidemiology; D013921:Thrombocytopenia / Q000453:epidemiology* / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents