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Clinical Assessment and Management of Cytopenias in Lupus Patients

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Abstract

Anemia, leukopenia, and/or thrombocytopenia can occur as a result of non-immune- and immune-mediated mechanisms in patients with systemic lupus erythematosus. Although the differential diagnosis of these cytopenias is broad and warrants a thorough evaluation, lupus disease activity and medications are common etiologic factors. Corticosteroids are the mainstay of initial treatment for immune-mediated hemolytic anemia and severe thrombocytopenia; immunosuppressive agents such as mycophenolate mofetil or azathioprine are often added for their steroid-sparing effects. Rituximab and intravenous immunoglobulin can be considered for refractory cytopenias based on a large body of anecdotal evidence and case series. Newer biologic agents such as belimumab or epratuzumab have yet to be studied specifically in systemic lupus erythematosus–mediated hematologic disorders.

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Disclosure

Dr. Erkan has served as an investigator for multiple lupus clinical trials (Genentech, Human Genome Sciences, Merck & Co., EMD Serono, and Eli Lilly and Company); has served as a consultant for Genentech; and has received research grant support from the Lupus Clinical Trials Consortium. Dr. Levine reported no potential conflicts of interest relevant to this article.

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  1. Division of Rheumatology, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY, 10021, USA

    Alana B. Levine & Doruk Erkan

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  1. Alana B. Levine
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  2. Doruk Erkan
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Correspondence to Alana B. Levine.

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Levine, A.B., Erkan, D. Clinical Assessment and Management of Cytopenias in Lupus Patients. Curr Rheumatol Rep 13, 291–299 (2011). https://doi.org/10.1007/s11926-011-0179-5

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