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.
Publication types
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Anemia / diagnosis
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Anemia / drug therapy
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Anemia / etiology
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Antibodies, Monoclonal, Murine-Derived / therapeutic use
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Azathioprine / therapeutic use
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Glucocorticoids / therapeutic use
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Humans
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Immunoglobulins, Intravenous / administration & dosage
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Immunosuppressive Agents / therapeutic use
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Leukopenia / diagnosis
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Leukopenia / drug therapy
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Leukopenia / etiology
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Lupus Erythematosus, Systemic / complications*
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Lupus Erythematosus, Systemic / diagnosis
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Lupus Erythematosus, Systemic / drug therapy
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Mycophenolic Acid / analogs & derivatives
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Mycophenolic Acid / therapeutic use
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Pancytopenia / diagnosis
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Pancytopenia / drug therapy
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Pancytopenia / etiology*
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Rituximab
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Thrombocytopenia / diagnosis
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Thrombocytopenia / drug therapy
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Thrombocytopenia / etiology
Substances
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Antibodies, Monoclonal, Murine-Derived
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Glucocorticoids
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Immunoglobulins, Intravenous
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Immunosuppressive Agents
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Rituximab
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Mycophenolic Acid
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Azathioprine